Vajda E, Mester A, Major T, Kiss K, Appel J, Magyar P, Makó E
Tüdögyógyászati Klinika, Semmelweis Orvostudományi Egyetem, Budapest.
Orv Hetil. 1998 Dec 27;139(52):3107-12.
During a period of 17 months, a total of 101 patients were examined by high resolution computed tomography (HRCT) whose minor focal changes revealed by chest X-ray raised the suspicion of diffuse infiltrative pulmonary disease. The disease of the interstitium was primarily caused by idiopathic pulmonary fibrosis (19%), autoimmune disease (18%), Boeck sarcoidosis (18%) as well as by specific (16%) and aspecific inflammation (12%). HRCT disclosed reticular (61%), nodular (55%), ground-glass opacity-like (48%), emphysematous (33%) and ring-like changes (17%). Also transbronchial excision was performed in 51 patients the results of which were compared to the changes observed during HRCT. Concerning fibrosis and inflammation, HRCT and histological analysis showed identical results in 70%. According to the authors observations, this technique is suitable for detection of fairly fine fibrotic, empysematous and inflammatory signs and for defining the activity of the individual disease as also for the selection of the optimal site of transbronchial excision. HRCT is a useful investigative method both for diagnosing diffuse infiltrative pulmonary disease as well as in following up the effectiveness of treatment.
在17个月的时间里,共有101例患者接受了高分辨率计算机断层扫描(HRCT)检查,这些患者胸部X线显示的轻微局灶性改变引发了对弥漫性浸润性肺病的怀疑。间质性疾病主要由特发性肺纤维化(19%)、自身免疫性疾病(18%)、结节病(18%)以及特异性(16%)和非特异性炎症(12%)引起。HRCT显示有网状改变(61%)、结节状改变(55%)、磨玻璃样改变(48%)、肺气肿样改变(33%)和环状改变(17%)。另外,对51例患者进行了经支气管切除术,并将其结果与HRCT观察到的改变进行了比较。关于纤维化和炎症,HRCT与组织学分析结果在70%的病例中一致。根据作者的观察,该技术适用于检测相当细微的纤维化、肺气肿和炎症征象,确定个体疾病的活动情况,以及选择经支气管切除术的最佳部位。HRCT是诊断弥漫性浸润性肺病以及随访治疗效果的一种有用的检查方法。