高分辨率计算机断层扫描中隐源性机化性肺炎的表现谱
The spectrum of presentations of cryptogenic organizing pneumonia in high resolution computed tomography.
作者信息
Mehrian Payam, Shahnazi Makhtoom, Dahaj Ali Ahmadi, Bizhanzadeh Sorour, Karimi Mohammad Ali
机构信息
Chronic Respiratory Disaeses Research Center, National Research Institute of Tuberculosis and Lung Disease, Masih-e-Daneshvari Hospital, Shahid Beheshti Medical University, Tehran, Iran.
Department of Radiology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Pol J Radiol. 2014 Dec 5;79:456-60. doi: 10.12659/PJR.891011. eCollection 2014.
BACKGROUND
Various radiologic patterns of cryptogenic organizing pneumonia (COP) in X-rays have been reported for more than 20 years, and later, in computed tomography scans. The aim of the present study was to describe the spectrum of radiologic findings on high resolution computed tomography (HRCT) scans in patients with COP.
MATERIAL/METHODS: HRCT scans of 31 sequential patients (mean age: 54.3±11 years; 55% male) with biopsy-proven COP in a tertiary lung center between 2009 and 2012 were reviewed by two experienced pulmonary radiologists with almost perfect interobserver agreement (kappa=0.83). Chest HRCTs from the lung apex to the base were performed using a 16-slice multi-detector CT scanner.
RESULTS
The most common HRCT presentation of COP was ground-glass opacity (GGO) in 83.9% of cases, followed by consolidation in 71%. Both findings were mostly asymmetric bilateral and multifocal. Other common findings were the reverse halo (48.4%), parenchymal bands (54.8%) and subpleural bands (32.3%). Pulmonary nodules were found in about one-third of patients and were frequently smaller than 5 mm in diameter. Both GGOs and consolidations were revealed more often in the lower lobes.
CONCLUSIONS
The main presentations of COP on HRCT include bilateral GGOs and consolidations in the lower lobes together with the reverse halo sign.
背景
20多年来，X线检查中已报道了隐源性机化性肺炎（COP）的各种放射学表现，随后在计算机断层扫描中也有相关报道。本研究的目的是描述COP患者高分辨率计算机断层扫描（HRCT）的放射学表现谱。
材料/方法：回顾了2009年至2012年期间在一家三级肺科中心31例经活检证实为COP的连续患者（平均年龄：54.3±11岁；55%为男性）的HRCT扫描结果，由两位经验丰富的肺放射科医生进行评估，观察者间一致性几乎完美（kappa=0.83）。使用16层多探测器CT扫描仪对从肺尖到肺底进行胸部HRCT扫描。
结果
COP最常见的HRCT表现是磨玻璃影（GGO），占83.9%的病例，其次是实变，占71%。这两种表现大多为双侧不对称和多灶性。其他常见表现为反晕征（48.4%）、实质带（54.8%）和胸膜下带（32.3%）。约三分之一的患者发现有肺结节，且直径通常小于5mm。GGO和实变在下叶更为常见。
结论
COP在HRCT上的主要表现包括双侧GGO、下叶实变以及反晕征。
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