煤工尘肺进行性块状纤维化的MRI表现

摘要

目的：分析煤工尘肺进行性块状纤维化（PMF）的MRI表现，探讨其MRI诊断价值。资料与方法对临床确诊的24例煤工尘肺PMF患者进行MRI检查，常规使用T1WI、T2WI及频谱预饱和反转恢复（SPIR）脂肪抑制序列，对病灶MRI信号及形态改变进行分析。结果24例煤工尘肺患者中，双侧肺PMF者16例，单侧肺病灶者8例。11例病灶位于上肺野，13例位于上中肺野。病灶形态：11例呈条块形，5例呈类圆形，8例呈不规则形。PMF在T1WI呈类似邻近软组织的等信号影，在T2WI及SPIR呈等低不均匀信号影，即在等低信号的病灶内可见斑条状更低信号影。结论煤工尘肺PMF在T2WI及SPIR相表现为等低不均匀块状信号影，其间可见不规则斑条状无信号影，具有一定的特征性表现，对煤工尘肺PMF的定性诊断有一定的价值。%PurposeTo explore MRI manifestations and diagnostic value of progressive massive fibrosis (PMF) in patient with coal workers' pneumoconiosis. Materials and Methods Twenty-four patients with PMF coal workers' pneumoconiosis underwent conventional MRI including T1WI, T2WI and SPIR. The signal intensity and morphological changes were analyzed.Results In 24 patients, there were 16 cases with bilateral pulmonary lesions and 8 cases with unilateral lesions. PMF was located in the upper lung field in 11 cases and in the upper and middle lung fields in 13 cases. The morphology of the lesions was stripe, round or irregular in shape. PMF were mainly isointense on T1WI, similar to adjacent soft tissue, and heterogeneous iso- or hypointense on T2WI and SPIR with patchy or stripe-like hypointensity.Conclusion PMF of coal workers' pneumoconiosis appears as a mass with iso- or hypointensity on T2WI and SPIR, with characteristic patchy-or stripe-like hypointensity. MRI is helpful in diagnosing PMF.