Akata S, Park J, Shindo H, Yoshimura M, Kakizaki D, Abe K
Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan.
Australas Radiol. 2007 Dec;51 Suppl:B235-7. doi: 10.1111/j.1440-1673.2007.01757.x.
We encountered a case showing a crazy-paving appearance on high-resolution computed tomography (HRCT), which mimicked various pulmonary diseases, e.g. pulmonary alveolar proteinosis, or non-specific interstitial pneumonia, but which we ultimately determined to be due to barium aspiration. The initial radiological findings were considered to be most likely due to pulmonary alveolar microlithiasis, because the crazy-paving appearance had high density, resembling calcification. However, distribution was limited to the area of dependent drainage of the right lung. Since a barium swallowing study had been performed 2 weeks before the CT examination, and since the follow-up HRCT showed improvement we reached a diagnosis of barium aspiration. Although barium aspiration may yield findings similar to other diseases with crazy-paving appearance, it is possible to identify it because of the limited distribution and high density.
我们遇到一例在高分辨率计算机断层扫描（HRCT）上表现为铺路石征的病例，该表现类似于多种肺部疾病，如肺泡蛋白沉积症或非特异性间质性肺炎，但我们最终确定其病因是误吸钡剂。最初的放射学表现被认为最有可能是肺泡微石症，因为铺路石征密度较高，类似钙化。然而，其分布仅限于右肺的重力引流区域。由于在CT检查前2周进行了钡剂吞咽研究，且后续的HRCT显示病情有所改善，我们最终诊断为误吸钡剂。尽管误吸钡剂可能产生与其他有铺路石征表现的疾病相似的影像学表现，但由于其分布局限且密度较高，仍有可能做出诊断。
