Guo Xiao-Juan, Bao Na, Zhang Lei, Dai Hua-Ping, Chen Qi, Zhai Ren-You, Zhai Xiao-Li, Liu Min, Wang Chen
Department of Radiology, Affiliated Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
Zhonghua Yi Xue Za Zhi. 2011 Jan 4;91(1):11-5.
To analyze the high-resolution computed tomographic (HRCT) findings of IPF (interstitial pulmonary fibrosis), NSIP (nonspecific interstitial pneumonia) and COP (cryptogenic organizing pneumonia) retrospectively through quantification methods and to explore their distinguishing features.
Observers with no prior knowledge of the diagnosis evaluated the frequency, extent and distribution of various thin-section CT findings in 29 males and 17 females. The mean age was 50 ± 10 years old (range: 25 - 76). They had a histological diagnosis of IPF (n = 19), nonspecific interstitial pneumonia (NSIP) (n = 14) and cryptogenic organizing pneumonia (COP) (n = 13).
Ground-glass opacity, thickening of bronchovascular bundles and interlobular septal thickening were frequent features of IPF and NSIP. The frequency and extent of honeycombing and bronchiolectasis were more found in IPF than in NSIP and COP (P < 0.05). The frequency and extent of air space consolidation were more found in COP than IPF (P < 0.05). There were more number of segments with traction bronchiectasis and less extent of air space consolidation in IPF than NSIP and COP. The number of segments with traction bronchiectasis was less in NSIP than that of IPF and COP.
The various subtypes of idiopathic interstitial pneumonias often have the distinguishing characteristics easily identified on HRCT. Bronchiolectasis and honeycombing are valuable features for IPF; air space consolidation is a valuable feature for COP. The features of NSIP are also found in both IPF and COP so that additional features are required for both.
通过定量方法回顾性分析特发性肺纤维化(IPF)、非特异性间质性肺炎(NSIP)和隐源性机化性肺炎(COP)的高分辨率计算机断层扫描(HRCT)表现,并探讨它们的鉴别特征。
对29例男性和17例女性进行评估,这些对象均事先未被告知诊断结果,由观察者评估各种薄层CT表现的频率、范围及分布情况。平均年龄为50±10岁(范围:25 - 76岁)。他们均有组织学诊断结果,其中IPF患者19例,非特异性间质性肺炎(NSIP)患者14例,隐源性机化性肺炎(COP)患者13例。
磨玻璃影、支气管血管束增厚及小叶间隔增厚是IPF和NSIP的常见表现。IPF中蜂窝状改变和细支气管扩张的频率及范围高于NSIP和COP(P < 0.05)。COP中实变影的频率及范围高于IPF(P < 0.05)。IPF中牵引性支气管扩张的节段数多于NSIP和COP,实变影范围小于NSIP和COP。NSIP中牵引性支气管扩张的节段数少于IPF和COP。
特发性间质性肺炎的不同亚型在HRCT上常有易于识别的鉴别特征。细支气管扩张和蜂窝状改变对IPF有诊断价值;实变影对COP有诊断价值。NSIP的表现同时存在于IPF和COP中,因此两者都需要更多的特征来鉴别。