Strube H, Becker-Gaab C, Reiser M, Treitl M
Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Campus Innenstadt, Pettenkoferstr. 8a, 80336, München, Deutschland.
Radiologe. 2010 Oct;50(10):872-8. doi: 10.1007/s00117-010-2002-0.
Vasculitis of small and medium sized vessels mostly affects several organ systems and causes unspecific symptoms. The trunk, lungs, heart and the gastrointestinal and urogenital tracts are most frequently involved. Due to an unclear clinical picture imaging is part and parcel of diagnostics. The knowledge of typical and rare imaging patterns as well as knowledge of the correct imaging method is crucial for classification. Projection radiography is still the gold standard for imaging of the lungs. Using computed tomography discrete ground-glass pattern opacities, nodules and consolidations can be depicted. In the abdomen computed tomography and magnetic resonance imaging can depict swelling of the intestinal wall. Digital subtraction angiography may contribute to further differentiation and reveal microaneurysms in cases of polyarteriitis nodosa.
中小血管血管炎大多累及多个器官系统并引起非特异性症状。躯干、肺、心脏以及胃肠道和泌尿生殖道最常受累。由于临床表现不明确，影像学检查是诊断的重要组成部分。了解典型和罕见的影像学表现以及正确的成像方法对于分类至关重要。胸部X线摄影仍是肺部成像的金标准。使用计算机断层扫描可以显示离散的磨玻璃样混浊、结节和实变。在腹部，计算机断层扫描和磁共振成像可以显示肠壁增厚。数字减影血管造影可能有助于进一步鉴别，并在结节性多动脉炎病例中发现微动脉瘤。
