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机化性肺炎(OP)的放射学与病理学相关性:图文综述

Radio-pathological correlation of organizing pneumonia (OP): a pictorial review.

作者信息

Zare Mehrjardi Mohammad, Kahkouee Shahram, Pourabdollah Mihan

机构信息

1 Department of Radiology, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Climax Radiology Education Foundation (CREF), Tehran, Iran.

出版信息

Br J Radiol. 2017 Mar;90(1071):20160723. doi: 10.1259/bjr.20160723. Epub 2017 Feb 17.

DOI:10.1259/bjr.20160723
PMID:28106480
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5601538/
Abstract

Since the description of cryptogenic organizing pneumonia in 1983 by Davison et al and the subsequent report on bronchiolitis obliterans organizing pneumonia by Epler et al, some reports have been published regarding the imaging features of organizing pneumonia (OP). In this pictorial review, we aimed to describe and illustrate different manifestations of OP on high-resolution CT (HRCT) accompanied by their histopathological correlations for a better comprehension of pathomechanism of the radiological findings. The main HRCT findings in OP include: consolidation, ground-glass opacification, perilobular opacity, reversed halo opacity, nodule or mass, parenchymal bands, bronchial wall thickening, bronchial dilatation, mediastinal lymphadenopathy and pleural effusion. In addition, we discuss the radiological differential diagnosis for each manifestation, as well as imaging evolution during patient follow-up, and two OP-related entities: the possibility of non-specific interstitial pneumonia development following OP and a relatively new rare entity related to OP called acute fibrinous and organizing pneumonia. For radiologists and physicians, a detailed knowledge of the potential radiological manifestations in OP is crucial for making a correct diagnosis and managing the patient properly. Moreover, some unnecessary lung biopsies will be avoided.

摘要

自1983年戴维森等人描述隐源性机化性肺炎以及随后埃普勒等人关于闭塞性细支气管炎机化性肺炎的报告以来,已有一些关于机化性肺炎(OP)影像特征的报道发表。在本图片综述中,我们旨在描述和展示OP在高分辨率CT(HRCT)上的不同表现及其组织病理学相关性,以便更好地理解影像学表现的发病机制。OP的主要HRCT表现包括:实变、磨玻璃样混浊、小叶周围混浊、反晕征、结节或肿块、实质带、支气管壁增厚、支气管扩张、纵隔淋巴结肿大和胸腔积液。此外,我们讨论了每种表现的影像学鉴别诊断,以及患者随访期间的影像演变,还有两个与OP相关的实体:OP后发生非特异性间质性肺炎的可能性以及一种与OP相关的相对较新的罕见实体,称为急性纤维素性和机化性肺炎。对于放射科医生和内科医生而言,详细了解OP潜在的影像学表现对于正确诊断和妥善治疗患者至关重要。此外,还可避免一些不必要的肺活检。

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