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石棉肺:高分辨率CT与病理的相关性

Asbestosis: high-resolution CT-pathologic correlation.

作者信息

Akira M, Yamamoto S, Yokoyama K, Kita N, Morinaga K, Higashihara T, Kozuka T

机构信息

Department of Radiology, National Kinki Chuo Hospital for Chest Diseases, Osaka, Japan.

出版信息

Radiology. 1990 Aug;176(2):389-94. doi: 10.1148/radiology.176.2.2367652.

Abstract

High-resolution computed tomography (HRCT) was performed in seven inflated and fixed postmortem lungs from seven asbestos-exposed patients with pathologically proved asbestosis. The parenchymal abnormalities seen at in vitro HRCT included thickened intralobular lines (n = 7), thickened interlobular lines (n = 7), pleural-based opacities (n = 7), parenchymal fibrous bands (n = 5), subpleural curvilinear shadows (n = 4), ground-glass appearance (n = 4), traction bronchiectasis (n = 4), and honeycombing (n = 2). The thickened intralobular lines were shown histologically to be due to peribronchiolar fibrosis. Thickened interlobular lines were due mainly to interlobular fibrotic thickening in four lungs and edema in three. The peribronchiolar fibrosis was most severe in the subpleural lung regions, creating curvilinear line shadows and pleural-based areas of opacity. Some subpleural fibrosis extended proximally along the bronchovascular sheath to create bandlike lesions. Areas of ground-glass appearance on HRCT scans were shown to be the result of mild alveolar wall and interlobular septal thickening due to fibrosis or edema. Postmortem HRCT findings were similar to premortem HRCT findings and correlated well with the pathologic findings of asbestosis.

摘要

对7名经病理证实患有石棉肺的石棉暴露患者的7个充气并固定的死后肺脏进行了高分辨率计算机断层扫描(HRCT)。体外HRCT所见的实质异常包括小叶内线增粗(n = 7)、小叶间线增粗(n = 7)、胸膜下混浊(n = 7)、实质纤维带(n = 5)、胸膜下曲线阴影(n = 4)、磨玻璃样外观(n = 4)、牵拉性支气管扩张(n = 4)和蜂窝状改变(n = 2)。组织学显示,小叶内线增粗是由于细支气管周围纤维化所致。小叶间线增粗主要是由于4个肺叶的小叶间纤维增厚和3个肺叶的水肿所致。细支气管周围纤维化在胸膜下肺区域最为严重,形成曲线状阴影和胸膜下混浊区域。一些胸膜下纤维化沿支气管血管鞘向近端延伸,形成带状病变。HRCT扫描上的磨玻璃样外观区域显示是由于纤维化或水肿导致的轻度肺泡壁和小叶间隔增厚所致。死后HRCT表现与生前HRCT表现相似,且与石棉肺的病理表现密切相关。

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