Essadki O, Grenier P
Service de Radiologie, Hôpital Pitié-Salpêtrière, Paris.
J Radiol. 1999 Jan;80(1):17-24.
Bronchiolitis includes a broad range of conditions with variable clinical, functional and morphological expression. Bronchiolar disease may be a primary or a secondary condition. Non-specific inflammatory changes are observed at the histology examination, involving respiratory and membranous bronchioles with or without extension to the alveoli. CT findings vary from subtle to quite marked abnormalities related to alveolar involvement, including small centrilobular lesions (nodular and branching linear opacities), ground-glass attenuation, and airspace consolidation. All are potentially reversible and treatable. Cicatrization processes may lead to constrictive bronchiolitis, an irreversible condition characterized by circumferential submucosal or periadventitial fibrosis causing an obstruction of the bronchiolar lumen. CT findings include decreased lung attenuation and expiratory air trapping within the areas of bronchiolar obstruction. The contrast with normally ventilated and perfused areas creates a mosaic perfusion pattern.
细支气管炎包括一系列临床、功能和形态表现各异的病症。细支气管疾病可能是原发性的，也可能是继发性的。组织学检查可观察到非特异性炎症变化，累及呼吸性细支气管和膜性细支气管，可伴有或不伴有肺泡受累。CT表现从与肺泡受累相关的轻微异常到相当明显的异常不等，包括小叶中心性小病变（结节状和分支状线性混浊）、磨玻璃样衰减和气腔实变。所有这些情况都具有潜在的可逆性且可治疗。瘢痕形成过程可能导致缩窄性细支气管炎，这是一种不可逆的病症，其特征是环形黏膜下或外膜周围纤维化导致细支气管腔阻塞。CT表现包括肺衰减降低以及细支气管阻塞区域内的呼气性气体潴留。与正常通气和灌注区域的对比形成了马赛克灌注模式。
