Keijsers Ruth G, Veltkamp Marcel, Grutters Jan C
Department of Nuclear Medicine, St. Antonius Hospital, Koekoekslaan 1, Utrecht, Nieuwegein 3435 CM, The Netherlands.
ILD Center of Excellence, St. Antonius Hospital, Koekoekslaan 1, Utrecht, Nieuwegein 3435 CM, The Netherlands.
Clin Chest Med. 2015 Dec;36(4):603-19. doi: 10.1016/j.ccm.2015.08.004.
Chest imaging has a central role in the diagnosis and monitoring of sarcoidosis. For staging of pulmonary disease on chest radiograph, Scadding stages are still widely used. High-resolution CT (HRCT), however, is more accurate in visualizing the various manifestations of pulmonary sarcoidosis as well its complications. A generally accepted HRCT scoring system is lacking. Fluorodeoxyglucose F 18 positron emission tomography can visualize disease activity better than conventional makers in a significant proportion of patients. In patients with extensive changes on HRCT but no parenchymal fluorodeoxyglucose F 18 uptake, prudence with regard to initiation or intensification of immunosuppressive treatment is warranted.
胸部影像学在结节病的诊断和监测中起着核心作用。对于胸部X线片上肺部疾病的分期，Scadding分期仍被广泛使用。然而，高分辨率CT（HRCT）在显示肺部结节病的各种表现及其并发症方面更为准确。目前缺乏一种普遍接受的HRCT评分系统。氟脱氧葡萄糖F 18正电子发射断层扫描在相当一部分患者中比传统指标能更好地显示疾病活动情况。对于HRCT有广泛改变但实质部位无氟脱氧葡萄糖F 18摄取的患者，在启动或加强免疫抑制治疗时应谨慎。
