Prince Jeffrey S, Duhamel David R, Levin David L, Harrell James H, Friedman Paul J
Department of Radiology, Division of Pulmonary and Critical Care Medicine, UCSD Medical Center, 200 W Arbor Dr, Mail Code 8756, San Diego, CA 92103-8756, USA.
Radiographics. 2002 Oct;22 Spec No:S215-30. doi: 10.1148/radiographics.22.suppl_1.g02oc02s215.
Nonneoplastic diseases of the central airways are uncommon but can be categorized as either focal or diffuse, although there is some overlap. Focal diseases include postintubation stenosis, postinfectious stenosis, posttransplantation stenosis, and various systemic diseases that may involve the airways and lead to focal stenosis (eg, Crohn disease, sarcoidosis, Behçet syndrome). Diffuse diseases of the central airways include Wegener granulomatosis, relapsing polychondritis, tracheobronchopathia osteochondroplastica, amyloidosis, papillomatosis, and rhinoscleroma. Conventional radiography is often the first step in the evaluation of suspected central airway disease and may be adequate in itself to identify the abnormality. However, computed tomography (CT) improves both the detection and characterization of central airway disease. Bronchoscopy remains the primary procedure for the diagnostic work-up of these disease entities. Nevertheless, a thorough radiologic evaluation with radiography and CT may demonstrate specific imaging findings (eg, calcification) that can help narrow the differential diagnosis and aid in the planning of bronchoscopy or therapeutic intervention.
中央气道的非肿瘤性疾病并不常见，但可分为局灶性或弥漫性，尽管存在一些重叠。局灶性疾病包括插管后狭窄、感染后狭窄、移植后狭窄以及各种可能累及气道并导致局灶性狭窄的全身性疾病（如克罗恩病、结节病、白塞综合征）。中央气道的弥漫性疾病包括韦格纳肉芽肿病、复发性多软骨炎、骨软骨瘤病性气管支气管病、淀粉样变性、乳头状瘤病和鼻硬结病。传统放射学检查通常是评估疑似中央气道疾病的第一步，其本身可能足以识别异常情况。然而，计算机断层扫描（CT）可改善中央气道疾病的检测和特征描述。支气管镜检查仍然是这些疾病实体诊断性检查的主要手段。尽管如此，通过放射学检查和CT进行的全面影像学评估可能会显示特定的影像学表现（如钙化），这有助于缩小鉴别诊断范围，并有助于支气管镜检查或治疗干预的规划。
