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表面活性蛋白 C 基因(SFTPC)突变相关性肺疾病:高分辨率计算机断层扫描(HRCT)表现及其与组织学分析的关系。

Surfactant protein C gene (SFTPC) mutation-associated lung disease: high-resolution computed tomography (HRCT) findings and its relation to histological analysis.

机构信息

Pediatric Radiology Department, Paris, France.

出版信息

Pediatr Pulmonol. 2010 Oct;45(10):1021-9. doi: 10.1002/ppul.21289.

Abstract

AIM OF THE STUDY

Determine high-resolution tomography (HRCT) scan characteristics in children with SFTPC mutation and correlate them to histological findings.

PATIENTS AND METHODS

This retrospective multicenter study included 15 children (7 females and 8 males) with SFTPC mutations. HRCT scans have been performed in all the children and lung biopsies in 8 children.

RESULTS

From all signs assessed on initial HRCT scans, ground-glass opacities (n =14, 93%) and lung cysts (n = 6, 40%) were predominant. Interlobular septal thickening (n = 1, 7%), air space consolidation (n = 1, 7%), paraseptal emphysema (n = 2, 13%), and pulmonary nodules (n = 1, 7%) were also found. Histological analysis revealed accumulation of macrophages in the alveolar lumen, type II pneumocyte hyperplasia, and alveolar septal thickening. Dilatation of the respiratory bronchiole and alveolar duct associated with muscular hyperplasia were also described. Interestingly, lung cysts on HRCT scans were associated with dilatation of terminal bronchioli and alveolar duct in lung biopsies.

CONCLUSION

In children with SFTPC mutations, HRCT scan finding was highly correlated to the histological findings and, as such, represent a useful tool to identify patients that may require SFTPC gene sequencing.

摘要

研究目的

确定 SFTPC 突变患儿的高分辨率 CT(HRCT)扫描特征,并将其与组织学发现相关联。

患者与方法

本回顾性多中心研究纳入了 15 名 SFTPC 突变患儿(7 名女性和 8 名男性)。所有患儿均行 HRCT 扫描,8 例行肺活检。

结果

在所有初始 HRCT 扫描评估的征象中,磨玻璃影(n=14,93%)和肺囊肿(n=6,40%)最为突出。间质性间隔增厚(n=1,7%)、气腔实变(n=1,7%)、间裂旁肺气肿(n=2,13%)和肺结节(n=1,7%)也有发现。组织学分析显示肺泡腔内巨噬细胞堆积、II 型肺泡上皮细胞增生和肺泡间隔增厚。还描述了呼吸细支气管和肺泡管的扩张以及肌纤维增生。有趣的是,HRCT 扫描上的肺囊肿与肺活检中终末细支气管和肺泡管扩张有关。

结论

在 SFTPC 突变患儿中,HRCT 扫描结果与组织学发现高度相关,因此是一种有用的工具,可以识别可能需要进行 SFTPC 基因测序的患者。

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