文章编号:1001 - 5949 (2002) 12 - 0716 - 03 ·论 著·

    胶原血管病性肺病的薄层 CT表现

    刘 芸 ,阎少宁 ,孟淑萍

    [摘要] 目的 探讨胶原血管病性肺病的薄层 CT 影像特征与病理相关性及用于鉴别诊断的价值。方法

    对经临床及实验室证实的 8 例类风湿性关节炎(RA) 、 2 例进行性多发性硬化(PSS) 、 12 例系统性红斑狼疮(SL E)及

    1例Bechet 病的胸部薄层 CT(包括部分高分辨率 CT)影像特征进行回顾性分析。观察内容包括蜂窝状影、索条状

    影、牵引性支气管扩张、磨玻璃密度、肺内结节、多发性肺实变、肺气肿、支气管血管束增粗、胸膜下结节、胸膜增厚、胸腔积液和胸膜钙化等。结果 (1)蜂窝状影、索条状影及牵引性支气管扩张为各类胶原血管性肺病的常见表现 ,以 RA、 PSS多见; (2)肺内结节及胸膜下结节为 RA的特征性表现; (3)多发性肺实变多为 SL E特征性表现; (4)胸

    腔积液、胸膜增厚以 SL E最多见; (5)胸膜钙化及肺内少量钙化为 PSS特征性表现。结论 根据薄层 CT的影像表

    现特征 ,可用于胶原血管性肺病的诊断和鉴别诊断。

    [关键词] 胶原血管病;薄层 CT ;高分辨率 CT

    [中图分类号] R814. 42 [文献标识码] A

    A study on thin - section CT f indings in pulmonary involvement in the collagen - vascular diseases

    L IU Yun , YA N S hao - ning , Meng S hu - ping. ( The Affiliated Hos p. of Ningxia Med. Coll . ,Yinchan 750004 ,China)

    [ Abstract] Objectives To find out the correlation of thin - section CT manifestations feature withpathological feature and the

    value of differential diagnosis in pulmonary involvement in the collagen diseases. Metheds Ret rospective analysis has been made of 8

    Rheumatoid Arthritis (RA) ,2 Progressive systemic sclerosis (Pss) ,12 Systemic lupus erytehematosus (SL E) and 1 Bechet’ s syndrome

    in lung thin - section CT features ,all of them were proved by clinic and laboratory results. The following were recorded : (1) honey2

    combing , linear opacity , t raction bronchiectasis ,ground - glass opacity , pulmonary nodule ,multi - pulmonary consolidation , emphy2

    sema , peribronchovascular interstitial thickening , subpleural nodule ,pleural thickening pleurorrhea and pleural calcification , et al .

    Results honeycombing ,linear opacity and t raction bronchietasis are the common a ppearances of all pulmonary collagen diseases , it is

    commonly seen in RA and Pss in this study. (2) pulmonary nodule and subpleural nodule are the characteristics findings in RA. (3) mul2

    ti - pulmonary consolidation is majority feature in SL E. (4) pleurorrhea and pleural thickening are most commonly seen in SL E . (5)

    pleural calcification and internal - pulmonary calcification are the characteristic a ppearances of Pss. Conclusions According to thin -

    section CT manifestation features , it can use in the differential dia gnosis in pulmonary involvement in the collagen diseases.

    [ Key words] Col lagen - vascular diseases ; Thin - sect ion CT ; High - resolut ion CT

    胶原血管病性肺病是指结缔组织病变侵及肺组

    织的一组肺部病变 ,全称胶原血管病致间质性肺疾

    病。由于结缔组织病是一种侵犯全身结缔组织的多

    系统疾病 ,而肺组织又是血管及结缔组织丰富的器

    官 ,故常受侵。常见的疾病有类风湿性关节炎(RA) 、进行性多发性硬化( PSS) 、系统性红斑狼疮( SL E) 、多发性肌炎、皮肌炎(PM - DM) 、复发性多发性软管

    炎(RP) 、混合性结缔组织病(MCTD) 、干燥综合征

    (SS) 、白塞氏病(Bechet )等 ,这些病大多都不同程度

    地累及肺的间质组织和血管及胸膜 ,而引起一系列

    的肺间质性病变表现[1 ]。大多表现为肺间质纤维

    化、蜂窝、磨玻璃密度 ,小叶间隔增厚、小结节影及胸

    [作者单位]宁夏医学院附属医院,宁夏 银川 750004

    [作者简介]刘芸,女(1967 - ) ,河北籍,汉族,主治医师,学士学位,主要从事胸、腹部、乳腺疾病影像诊断。

    膜结节、胸水 ,但由于各类疾病的病理基础不同 ,其

    影像表现也有不同的侧重点。

    1 资料与方法

    1. 1 一般资料:本文收集 RA 8 例 ,其中男6 例 ,女2

    例 ,平均年龄 28 - 54 岁;PSS 2 例 ,均为女性 ,45 - 50

    岁;SL E 12 例 ,均为女性 ,年龄 20 - 42 岁;Bechet 病

    1 例 ,为女性 ,31 岁 ......