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结节病在各器官的放射学表现。

Radiologic manifestations of sarcoidosis in various organs.

作者信息

Koyama Takashi, Ueda Hiroyuki, Togashi Kaori, Umeoka Shigeaki, Kataoka Masako, Nagai Sonoko

机构信息

Department of Radiology, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.

出版信息

Radiographics. 2004 Jan-Feb;24(1):87-104. doi: 10.1148/rg.241035076.

Abstract

Sarcoidosis is a systemic disorder of unknown cause with a wide variety of clinical and radiologic manifestations. The diagnosis is usually made on the basis of these manifestations supported by histologic findings. Systemic manifestations (eg, Löfgren syndrome, Heerfordt syndrome) are commonly seen at clinical examination. Bilateral hilar lymphadenopathy is the most common radiologic finding-frequently with associated pulmonary infiltrates-and typically has a characteristic perivascular distribution at high-resolution chest computed tomography. Radiologic findings in the short tubular bones of the hands and feet and magnetic resonance imaging findings of nodular involvement of muscle are often sufficient to raise suspicion for sarcoidosis. In the liver, spleen, kidneys, and scrotum, coalescing granulomas form nodules whose imaging features may occasionally be nonspecific, although familiarity with the relevant clinical settings will be helpful in recognizing the presence of sarcoidosis. Radiologic recognition of cardiac and central nervous system involvement is also important because patients may be only mildly symptomatic. The clinical course and prognosis of sarcoidosis are highly variable, often correlating with the mode of onset. Familiarity with the clinical and radiologic features of sarcoidosis in various anatomic locations plays a crucial role in diagnosis and management.

摘要

结节病是一种病因不明的全身性疾病,具有多种多样的临床和放射学表现。诊断通常基于这些表现并结合组织学检查结果做出。全身表现(如 Löfgren 综合征、Heerfordt 综合征)在临床检查中较为常见。双侧肺门淋巴结肿大是最常见的放射学表现,常伴有肺部浸润,在高分辨率胸部计算机断层扫描中通常具有特征性的血管周围分布。手部和足部短管状骨的放射学表现以及肌肉结节样受累的磁共振成像表现常常足以引起对结节病的怀疑。在肝脏、脾脏、肾脏和阴囊中,融合的肉芽肿形成结节,其影像学特征偶尔可能不具有特异性,尽管熟悉相关临床情况有助于识别结节病的存在。心脏和中枢神经系统受累的放射学识别也很重要,因为患者可能症状较轻。结节病的临床病程和预后差异很大,通常与发病方式相关。熟悉结节病在不同解剖部位的临床和放射学特征在诊断和管理中起着至关重要的作用。

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