Federal University of Rio de Janeiro, Rio de Janeiro.
Federal University of Rio de Janeiro, Rio de Janeiro.
Chest. 2012 May;141(5):1260-1266. doi: 10.1378/chest.11-1050. Epub 2011 Oct 20.
The purpose of this study was to evaluate the high-resolution CT (HRCT) scan findings of patients with the reversed halo sign (RHS) and to identify distinguishing features among the various causes.
Two chest radiologists reviewed the HRCT scans of 79 patients with RHS and determined the CT scan findings by consensus. We studied the morphologic characteristics, number of lesions, and presence of features associated with RHS.
Forty-one patients presented with infectious diseases (paracoccidioidomycosis, TB, zygomycosis, invasive pulmonary aspergillosis, Pneumocystis jiroveci pneumonia, histoplasmosis, cryptococcosis), and 38 presented with noninfectious diseases (cryptogenic organizing pneumonia, pulmonary embolism, sarcoidosis, edema, lepidic predominant adenocarcinoma [formerly bronchiolo-alveolar carcinoma], granulomatosis with polyangiitis [Wegener]). The RHS walls were smooth in 58 patients (73.4%) and nodular in 21 patients (26.6%). Lesions were multiple in 40 patients (50.6%) and single in 39 patients (49.4%).
The presence of nodular walls or nodules inside the halo of the RHS is highly suggestive of granulomatous diseases.
本研究旨在评估具有反晕征（RHS）患者的高分辨率 CT（HRCT）扫描结果，并确定各种病因之间的鉴别特征。
两名胸部放射科医生回顾了 79 例 RHS 患者的 HRCT 扫描结果，并通过共识确定了 CT 扫描结果。我们研究了形态特征、病变数量以及与 RHS 相关的特征的存在。
41 例患者患有传染病（球孢子菌病、TB、毛霉病、侵袭性肺曲霉病、卡氏肺孢子虫肺炎、组织胞浆菌病、隐球菌病），38 例患者患有非传染性疾病（特发性机化性肺炎、肺栓塞、结节病、水肿、贴壁为主型腺癌[原细支气管肺泡癌]、肉芽肿性多血管炎[韦格纳]）。58 例患者（73.4%）的 RHS 壁光滑，21 例患者（26.6%）的 RHS 壁呈结节状。40 例患者（50.6%）的病变为多发性，39 例患者（49.4%）的病变为单发。
RHS 晕环内存在结节状壁或结节状提示为肉芽肿性疾病。
