McGuinness G, Naidich D P, Jagirdar J, Leitman B, McCauley D I
Department of Radiology, New York University Medical Center-Bellevue Hospital, NY.
J Comput Assist Tomogr. 1992 May-Jun;16(3):384-90. doi: 10.1097/00004728-199205000-00009.
High-resolution CT (HRCT) and chest radiographs were compared in nine patients with miliary lung disease. In all cases, miliary disease was documented to be infectious in etiology; six of these patients proved to be human immunodeficiency virus (HIV) positive. A mixture of both sharply and poorly defined 1-3 mm nodules was seen in all cases, many of the latter having an appearance indistinguishable from airspace nodules. Other features attributable to the presence of nodules included nodular interlobular septae, nodular irregularity of vessels, subpleural dots, and studded fissures. Diffuse intra- and interlobular septal thickening also proved common, seen in all but one case (91%). Based on limited HRCT-pathologic correlation, CT findings appear primarily to be due to granulomatous foci developing in a seemingly random distribution involving both pulmonary airspaces as well as the interstitium. It is concluded that in the appropriate clinical setting this constellation of findings is characteristic of miliary disease; the role of HRCT especially in the early diagnosis of miliary disease in HIV positive patients remains to be determined prospectively.
对9例粟粒性肺病患者的高分辨率CT（HRCT）和胸部X光片进行了比较。在所有病例中，粟粒性疾病经证实病因均为感染性；其中6例患者被证明为人类免疫缺陷病毒（HIV）阳性。所有病例均可见边界清晰和边界不清的1-3毫米结节混合存在，许多边界不清的结节外观与气腔结节难以区分。结节存在的其他特征包括结节状小叶间隔、血管结节状不规则、胸膜下小点和结节状增厚的叶间裂。弥漫性小叶内和小叶间隔增厚也很常见，除1例（91%）外均可见。基于有限的HRCT与病理的相关性，CT表现似乎主要是由于肉芽肿灶以看似随机的分布发展，累及肺气腔和间质。结论是，在适当的临床环境中，这一系列表现是粟粒性疾病的特征；HRCT在HIV阳性患者粟粒性疾病早期诊断中的作用仍有待前瞻性研究确定。
