Jung J I, Kim H, Park S H, Kim H H, Ahn M I, Kim H S, Kim K J, Chung M H, Choi B G
Department of Radiology, St Mary's Hospital, College of Medicine, The Catholic University of Korea, 62 Yeouido-dong, Youngdungpo-gu, Seoul 150-010, Korea.
Br J Radiol. 2001 Jun;74(882):490-4. doi: 10.1259/bjr.74.882.740490.
The objective was to analyse the potential of CT to distinguish pneumonic-type bronchioloalveolar cell carcinoma (BAC) from infectious pneumonia. The study consisted of 21 patients with pathologically proven BAC and 30 patients with infectious pneumonia. Both groups of patients had patchy or diffuse consolidation of more than half the area of a lobe or lobes on CT. CT findings in these two groups were compared with regard to morphological appearance, including CT angiogram, air bronchogram, mucous bronchogram, contrast enhancement pattern, pseudocavitation, cavity with air-fluid level, location, satellite lesion, ground-glass opacity and bulging of the interlobar fissure. Air-filled bronchi were morphologically analysed as dilatation, stretching, sweeping, widening of the branching angle, squeezing and crowding. Lymphadenopathy and pleural effusion were also analysed. CT findings favouring the diagnosis of BAC included an air-filled bronchus within the consolidation with stretching, squeezing, sweeping, widening of the branching angle and bulging of the interlobar fissure (p<0.05). It is concluded that CT may be helpful in differentiating pneumonic-type BAC from infectious pneumonia if the air-filled bronchus within the consolidation shows stretching, squeezing, widening of the branching angle or bulging of the interlobar fissure.
目的是分析CT区分肺炎型细支气管肺泡癌（BAC）与感染性肺炎的潜力。该研究包括21例经病理证实的BAC患者和30例感染性肺炎患者。两组患者在CT上均有一个或多个肺叶超过一半面积的斑片状或弥漫性实变。对这两组患者的CT表现进行比较，包括形态学表现，如CT血管造影、空气支气管征、黏液支气管征、对比增强模式、假空洞、气液平面空洞、位置、卫星灶、磨玻璃影和叶间裂膨隆。对含气支气管进行形态学分析，包括扩张、拉长、推移、分支角增宽、受压和拥挤。还分析了淋巴结肿大和胸腔积液情况。支持BAC诊断的CT表现包括实变区内含气支气管伴拉长、受压、推移、分支角增宽和叶间裂膨隆（p<0.05）。结论是，如果实变区内的含气支气管表现为拉长、受压、分支角增宽或叶间裂膨隆，CT可能有助于区分肺炎型BAC与感染性肺炎。
