Screaton N J, Sivasothy P, Flower C D, Lockwood C M
Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
Clin Radiol. 1998 Nov;53(11):809-15. doi: 10.1016/s0009-9260(98)80191-8.
To describe the computed tomography (CT) appearances of tracheal stenosis in Wegener's granulomatosis (WG) and to assess the additional value of reformatted images.
Ten patients with tracheal involvement by WG were assessed with spiral CT and both coronal and three-dimensional surface shaded images were generated. Fibreoptic bronchoscopy was also performed in all patients.
Ninety per cent of lesions were situated in the subglottic region. In all cases there was circumferential mucosal thickening, in nine cases extending over a relatively short distance (mean 2.4 cm). The degree of narrowing of the axial luminal diameter ranged from 23% to 100%. In three patients there was contiguous involvement of the vocal cords evident on CT, two further cases with mild vocal cord inflammation were identified bronchoscopically. Other CT findings included mucosal irregularity and ulceration (50%), and involvement of the tracheal cartilages (20%).
Wegener's granulomatosis may involve the trachea with resultant stenosis. Spiral CT is an easily performed, non-invasive technique which provides accurate assessment of tracheal lesions and is complementary to bronchoscopy. The main additional advantage of coronal reformatted images was our added confidence in defining the upper and lower limits of lesions and in the evaluation of vocal cord involvement.
描述韦格纳肉芽肿（WG）气管狭窄的计算机断层扫描（CT）表现，并评估重组图像的附加价值。
对10例气管受累的WG患者进行螺旋CT检查，并生成冠状面和三维表面阴影图像。所有患者均进行了纤维支气管镜检查。
90%的病变位于声门下区。所有病例均有环形黏膜增厚，9例累及范围相对较短（平均2.4 cm）。轴向管腔直径的狭窄程度为23%至100%。3例患者CT显示声带连续受累，另外2例经支气管镜检查发现轻度声带炎症。其他CT表现包括黏膜不规则和溃疡（50%），以及气管软骨受累（20%）。
韦格纳肉芽肿可累及气管导致狭窄。螺旋CT是一种操作简便、无创的技术，可准确评估气管病变，是支气管镜检查的补充。冠状面重组图像的主要附加优势在于，我们在确定病变的上下限以及评估声带受累方面更有信心。
