Brauner M W, Grenier P, Mompoint D, Lenoir S, de Crémoux H
Department of Radiology, Hôpital Jean Verdier, Bondy, France.
Radiology. 1989 Aug;172(2):467-71. doi: 10.1148/radiology.172.2.2748828.
Forty-four patients with histologically confirmed sarcoidosis were prospectively studied with high-resolution computed tomography (CT). Nodules were seen in all cases. They were isolated in 19 cases and associated with other lesions in 25 cases. Other abnormalities were irregular interfaces (n = 18, 41%), linear network (n = 14, 32%), thickening of the pleural surface (n = 9, 20%), ground-glass opacities (n = 7, 16%), lung distortion (n = 11, 25%), traction bronchiectasis (n = 3, 7%), and network of air-filled cavities (n = 3, 7%). Predominant sites of lesions were the upper and middle zones (n = 30, 68%) and posterior zones (n = 13, 30%). Nodular abnormalities were noted at CT in six cases in which the pulmonary parenchyma appeared normal on radiographs. Lung distortion was noted at CT in eight cases without visible fibrosis on chest radiographs. The majority of patients with lung distortion (nine of 11, 82%) had disease of greater than a years duration. CT improved sensitivity for the detection of all types of lesions, mainly lung distortion. Low but significant correlations were found between visual score at CT and total lung capacity, vital capacity, forced expiratory volume in 1 second, and diffusing capacity.
对44例经组织学确诊的结节病患者进行了高分辨率计算机断层扫描(CT)前瞻性研究。所有病例均可见结节。其中19例为孤立性结节,25例伴有其他病变。其他异常包括不规则界面(18例,41%)、线状影(14例,32%)、胸膜表面增厚(9例,20%)、磨玻璃影(7例,16%)、肺扭曲(11例,25%)、牵拉性支气管扩张(3例,7%)以及含气腔隙影(3例,7%)。病变主要位于上、中区(30例,68%)和后区(13例,30%)。6例胸片上肺实质正常的患者CT表现为结节异常。8例胸片未见明显纤维化的患者CT表现为肺扭曲。大多数肺扭曲患者(11例中的9例,82%)病程超过1年。CT提高了对所有类型病变的检测敏感性,主要是肺扭曲。CT视觉评分与肺总量、肺活量、第1秒用力呼气量和弥散量之间存在低但显著的相关性。