Takiguchi Y, Uchiyama T, Nagao K, Fujita A, Hashizume I, Kuriyama T
Department of Chest Medicine, School of Medicine, Chiba University, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Mar;32(3):233-8.
We evaluated longitudinal changes in chest CT images in six cases (5 males and one female, age: 35-57 yr) of pulmonary alveolar proteinosis treated with bronchopulmonary lavage. Chest CT images on admission showed a mixed pattern of air-space consolidation and reticular or reticulonodular shadows in most cases and showed a peripheral clear zone in all cases. These shadows gradually diminished after bronchopulmonary lavage. Some cases revealed early improvement in the hilar zone while others had equal improvement in all lung lesions. In one case, consolidation was changed into reticular shadows by treatment. Previous reports have indicated that "interstitial shadows which disappeared with lavage" reflect edematous thickening of interlobular septa. However, our longitudinal evaluation suggests that interstitial shadows on CT images may reflect not only real interstitial infiltration but also inhomogeneous distribution of intralobular deposits.
我们评估了6例（5例男性，1例女性，年龄35 - 57岁）接受支气管肺灌洗治疗的肺泡蛋白沉积症患者胸部CT图像的纵向变化。入院时的胸部CT图像在大多数病例中显示为气腔实变与网状或网状结节状阴影的混合模式，且所有病例均显示外周清晰带。这些阴影在支气管肺灌洗后逐渐减轻。一些病例在肺门区显示早期改善，而其他病例在所有肺部病变中改善程度相同。1例患者经治疗后实变转变为网状阴影。既往报告表明，“灌洗后消失的间质阴影”反映小叶间隔的水肿增厚。然而，我们的纵向评估提示，CT图像上的间质阴影不仅可能反映真正的间质浸润，还可能反映小叶内沉积物的不均匀分布。
