Emad Y, Abdel-Razek N, Gheita T, el-Wakd M, el-Gohary T, Samadoni A
Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Clin Rheumatol. 2007 Jun;26(6):879-84. doi: 10.1007/s10067-006-0408-x. Epub 2006 Sep 21.
Pulmonary artery aneurysm is the best-defined type of pulmonary disease in Behçet's disease (BD) with an important morbidity and mortality. The objective of this study was to assess the contribution of high-resolution dynamic chest CT imaging for one of the most serious aspects of BD: pulmonary artery aneurysm and other pulmonary parenchymal involvement. Sixteen BD patients were recruited for this study, (14 men, 87.5%, and 2 women, 12.5%). All patients fulfilled the 1990 American College of Rheumatology criteria for classification of BD [International Study Group for Behçet's Disease, Lancet 335:1078-1080, (1990)]. All patients underwent thorough history taking, full clinical examination, and routine laboratory investigations. Plain chest X-rays and pulmonary CT angiography were performed on all patients in an attempt to assess the pulmonary vasculature and lung parenchyma. Pulmonary vascular abnormalities were as follows: pulmonary artery aneurysms of varying sizes in nine patients (56.3%), main pulmonary artery ectasia in two patients (12.5%), pulmonary artery embolism in two patients (12.5%), venacaval thrombosis in seven patients (43.8%), and pulmonary venous varices in four patients (25%). Pulmonary parenchymal abnormalities were as follows: three patients (18.8%) with mild central bronchiectasis, one patient (6.3%) with atelectasis, one patient (6.3%) with subpleural nodule, and four patients (25%) with interstitial lung disease. Eight of the male patients were smokers. Multislice CT is useful in demonstrating the entire spectrum of thoracic manifestations of BD. Multislice CT is noninvasive and provides excellent delineation of the vessel lumen and wall and perivascular tissues, as well as detailed information concerning the lung parenchyma, pleura, and mediastinal structures.
肺动脉瘤是白塞病(BD)中定义最明确的肺部疾病类型,具有重要的发病率和死亡率。本研究的目的是评估高分辨率动态胸部CT成像对BD最严重的方面之一:肺动脉瘤和其他肺实质受累的作用。本研究招募了16例BD患者(14例男性,占87.5%;2例女性,占12.5%)。所有患者均符合1990年美国风湿病学会BD分类标准[白塞病国际研究组,《柳叶刀》335:1078 - 1080,(1990年)]。所有患者均进行了详细的病史采集、全面的临床检查和常规实验室检查。对所有患者进行了胸部X线平片和肺CT血管造影,以评估肺血管系统和肺实质。肺血管异常情况如下:9例患者(56.3%)有不同大小的肺动脉瘤,2例患者(12.5%)有主肺动脉扩张,2例患者(12.5%)有肺动脉栓塞,7例患者(43.8%)有腔静脉血栓形成,4例患者(25%)有肺静脉瘤样扩张。肺实质异常情况如下:3例患者(18.8%)有轻度中央型支气管扩张,1例患者(6.3%)有肺不张,1例患者(6.3%)有胸膜下结节,4例患者(25%)有间质性肺疾病。8例男性患者为吸烟者。多层螺旋CT有助于显示BD胸部表现的全貌。多层螺旋CT是非侵入性的,能很好地显示血管腔、壁及血管周围组织,还能提供有关肺实质、胸膜和纵隔结构的详细信息。