Objective To evaluate the CT imaging features of pulmonary Wegener′s granulomatosis, and to im-prove the diagnostic accuracy of the disease. Methods CT manifestations of the 4 cases with Wegener′s granulo-matosis in lung confirmed clinically or by operation were analyzed retrospectively, to summarize its imaging character-istic. CT chest scan was undergone in 4 cases, including 3 males and 1 female ,aged 38-64 years old with the average of 54 years old. Results Of 4 cases with wegener′s granulomatosis, 3 cases showed pulmonary multiple lesions, in-cluding multiple nodules or tumor 1 case showed a single lesion ,including single tumor. The accompanied signs in-cluded speculation(4 cases), cavitation(1 case), vascular sign(2 case), lymph node enlargement(1 case), pleural ir-regularities (3 cases). The radiographic manifestations varied among the cases, nodules and cavitations in the lungs were the signs that were most frequently found,and patchy infiltration were also observed. Four PWG patients were misdiagnosed as lung cancer, tuberculosis, which implied that the clinical manifestations of PWG were similar to the clinical symptoms of lung cancer, tuberculosis, Those were the reasons leading to misdiagnosis of PWG. Conclusion The clinical symptoms and radiographic manifestations of PWG have no specificity, and the disease can be easily misdiagnosed. Tissue biopsy can be important means for PWG diagnosis.%目的 探讨肺部韦格纳肉芽肿病(PWG)的CT影像学表现特点,提高该病诊断的准确性. 方法对4例经肺穿刺活检和临床综合资料证实的肺部韦格纳肉芽肿患者的CT表现进行回顾性分析, 总结其影像学特征.4例均行胸部CT扫描,其中男3例,女1例,年龄38~64岁,平均(54.0±0.5)岁.结果 多发病变3例,均为多发结节或肿块.单发病变1例,为单发肿块.伴随征象包括毛刺征象4例;空洞1例;供养血管征2例;淋巴结肿大1例;胸膜粘连3例.肺部病变影像学表现多样,结节(或)肿块及空洞是最常见表现,可呈斑片状侵润改变.4例PWG患者误诊为肺癌,肺结核,提示PWG和肺癌及肺结核有许多相似之处,极易误诊. 结论 PWG临床症状及胸部影像均无特异性表现,容易误诊. 组织活检是明确诊断的重要方法.
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