胸部结节病CT影像表现

摘要

Purpose: To analyze the CT findings of thoracic sarcoidosis and find out typical and atypi cal features, in order to improve the recognition and diagnosis. Methods: The CT scans of 38 patients with confirmed thoracic sarcoidosis were retrospectively analyzed. The patients included 12 males and 26 female, and the age range from 17 to 56 years (mean 45.2 years) . The scan thickness was 7mm or 5mm,and the reconstruction thickness was Imm or 1.25mm. Thirty - two of them were undergone enhanced scanning. Results: The enlargement of lymph nodes was seen in all patients. Thirty - three patients (86.8％) had typical pattern of enlargement of lymph nodes in symmetrical, bilateral hilar, right- sided paratracheal and aorta - pulmonary window. The others was atypical. Pulmonary changes were seen in 21 patients(55.3 ％ ) . Among them, 12 patients (57.1％ ) had typical reticulonodular changes. An extraordinary finding including patchy, irregular nodule, and reticulation in bilateral lung base was found in 5 patients. Three of them were also had atypical lymph nodes. Conclusion: The typical pattern of enlargement of lymph nodes in symmetrical, bilateral hilar, right - sided paratracheal and aorta - pulmonary window was seen in most patients with thoracic sarcoidosis, which would be specific. The patchy, irregular, and reticular lesions in bilateral lung base might be an indicative for the diagnosis of thoracic sarcoidosis.%目的:分析胸部结节病cT影像,探讨其典型性及小典型件,以进一步提高认识,帮助诊断.方法:回顾性分析38例确诊的胸部结节病CT图像,男12例,女26例,年龄17-56岁,平均45.2岁CT扫描层厚7mm或5mm,同时均有1mm或1.25ram薄层图像,32例完成增强扫描结果:全部有肺门或纵隔淋巴结肿大,典型)双侧肺门对称件淋巴结肿人及纵隔右气管旁和主肺动脉窗淋巴结肿大33例(86.8%).出现肺部病,变21例(55.3%),典型网织结节改变12例(57.1%),5例出现奇特的双下肺斑片和不规则结节伴有网格线影.不典型淋巴结表现的5例结节病中3例有奇特肺内改变.结论:胸部结节病多数有双侧肺门对称性淋巴结肿大及纵隔右气管旁和主肺动脉窗淋巴结肿大的典型表现,有高特异性.奇特的双下肺斑片和不规则结节伴有网格线影可能有助于不典型胸部结节病的诊断.