Johkoh T, Müller N L, Ichikado K, Yoshida S, Honda O, Mihara N, Higashi M, Tomiyama N, Nakamura H, Nagareda T
Department of Radiology, Osaka University Medical School, Japan.
J Comput Assist Tomogr. 1999 Mar-Apr;23(2):174-80. doi: 10.1097/00004728-199903000-00003.
The purpose of this study was twofold: to evaluate the change in size of honeycomb cysts with respiration using inspiratory-expiratory spiral volumetric CT (I-E SVCT) and to establish the pathologic basis of this change.
Ninety-seven patients, who had honeycombing associated with end-stage pulmonary fibrosis on end-inspiratory 1 to 2 mm collimation high-resolution CT (HRCT), underwent I-E SVCT (3 mm collimation, pitch 1, breath-hold time 20 s, reconstruction interval 1 mm, FOV 16-20 cm, high frequency algorithm). I-E SVCT scans were assessed on images obtained in the transverse plane and volumetric sagittal, coronal, and oblique reformations. The histologic findings were assessed in four inflated and fixed lungs that showed honeycombing at postmortem HRCT.
In 63 patients (65%), a small percentage of the cysts did not change in size at end-expiration, while in the remaining patients, all the cysts decreased in size. Assessment of volumetric multiplanar reformations showed that cysts that decreased in size during exhalation communicated with airways and represented bronchiolectasis rather than true cysts, while the other cysts did not communicate with the airways. Similar findings were found in pathologic specimens.
The majority of, but not all, honeycomb cysts seen on HRCT represent dilated bronchioles that communicate with the proximal airways and change in size with respiration.
本研究有两个目的：使用吸气-呼气螺旋容积CT（I-E SVCT）评估蜂窝状囊肿大小随呼吸的变化，并确立这种变化的病理基础。
97例在吸气末1至2毫米准直高分辨率CT（HRCT）上有与终末期肺纤维化相关的蜂窝状改变的患者，接受了I-E SVCT检查（3毫米准直，螺距1，屏气时间20秒，重建间隔1毫米，视野16 - 20厘米，高频算法）。I-E SVCT扫描在横断面以及容积矢状面、冠状面和斜位重建图像上进行评估。对4例在尸检HRCT上显示有蜂窝状改变的充气固定肺组织的组织学发现进行了评估。
63例患者（65%）中，一小部分囊肿在呼气末大小未改变，而在其余患者中，所有囊肿大小均减小。容积多平面重建评估显示，呼气时大小减小的囊肿与气道相通，代表细支气管扩张而非真正的囊肿，而其他囊肿与气道不相通。在病理标本中也发现了类似的结果。
HRCT上所见的大多数（但并非全部）蜂窝状囊肿代表与近端气道相通且大小随呼吸变化的扩张细支气管。
