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特发性肌炎相关间质性肺病的高分辨率 CT 表现

High-Resolution CT Findings of Myositis-Related Interstitial Lung Disease.

机构信息

Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.

出版信息

Medicina (Kaunas). 2021 Jul 6;57(7):692. doi: 10.3390/medicina57070692.

Abstract

Myositis-related interstitial lung disease presents with a wide variety of lesions, ranging from chronic to acute. It can be divided into two main forms by the types of onsets, namely, chronic to subacute type showing nonspecific interstitial pneumonia (NSIP) or NSIP with an organizing pneumonia (OP)/fibrosing OP (FOP) pattern and acute type showing acute lung injury (ALI) to diffuse alveolar damage (DAD) pattern. Anti-aminoacyl tRNA Synthetase antibody-positive cases mainly show an NSIP or FOP pattern, whereas anti-melanoma differentiation-associated gene 5 antibody-positive cases show ALI to DAD pattern. Bilateral consolidation with or without ground-glass opacification with lower lobe predominance is common as a major pattern in all types, but the distribution or extent is sometimes different. The early detection of findings that indicate a rapid progressive course is vital. Diffuse cranio-caudal distribution and multiple ground-glass opacifications with random distribution might indicate a poorer prognosis.

摘要

肌炎相关性间质性肺病的病变表现多种多样,从慢性到急性不等。根据发病类型,可分为两种主要形式,即慢性至亚急性型表现为非特异性间质性肺炎(NSIP)或伴有机化性肺炎(OP)/纤维性 OP(FOP)模式的 NSIP,以及急性型表现为急性肺损伤(ALI)至弥漫性肺泡损伤(DAD)模式。抗氨酰基 tRNA 合成酶抗体阳性病例主要表现为 NSIP 或 FOP 模式,而抗黑色素瘤分化相关基因 5 抗体阳性病例则表现为 ALI 至 DAD 模式。所有类型中常见的主要表现为双侧实变影伴或不伴磨玻璃影,以下肺为主,但分布或程度有时不同。早期发现提示快速进展过程的表现至关重要。弥漫性头尾分布和随机分布的多发性磨玻璃影可能预示着预后较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa6e/8304263/4e42d7e51cd8/medicina-57-00692-g001.jpg

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