尘肺病合并特发性间质性肺炎(IIPs)的影像学表现
Imaging Manifestations of Pneumoconiosis with Idiopathic Interstitial Pneumonias
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摘要:
目的 研究尘肺病合并特发性间质性肺炎(IIPs)的影像学特点。 方法 对67 例尘肺病合并间质性肺炎的影像学资料进行分析,总结其影像学特点。 结果 67 例病例中并发59 例普通型间质性肺炎(UIP),占88.06%;并发2 例非特异性间质性肺炎(NSIP),占2.99%;2 例脱屑性间质性肺炎(DIP),占2.99%;1 例呼吸性细支气管炎伴间质性肺病(RB-ILD),占1.49%;1 例急性间质性肺炎(AIP),占1.49%;1 例淋巴细胞间质性肺炎(LIP),占1.49%;1 例隐源性机化性肺炎(COP),占1.49%。尘肺合并UIP 小阴影以p 为主者5 例,占8.47%,以s 影为主者54 例,占91.53%,大阴影为主者1 例,占1.69%,以s 影为主的尘肺合并UIP 较以p 影为主的尘肺合并UIP 的病例多,差异有统计学意义(P<0.01);尘肺合并IIPs 胸片表现以磨玻璃影、网织结节影、蜂窝影等为主;尘肺合并IIPs 高分辨率 CT(HRCT)表现以磨玻璃影、蜂窝影伴牵引性支气管扩张、小叶间隔增厚等改变为主。HRCT 显示,尘肺合并IIPs 磨玻璃影、蜂窝影伴牵引性支气管扩张、小叶间隔增厚较胸片明显,差异有统计学意义(P<0.01)。 结论 掌握尘肺病合并IIPs 的影像学特点对正确诊断尘肺病以及判断预后有重要意义。 Abstract:Objective To study the imaging features of pneumoconiosis merged with idiopathic interstitial pneumonias (IIPs). Methods A total of 67 cases of pneumoconiosis with interstitial pneumonia were included to the study. Results The 67 selected cases were composed of 59 cases (88.06%) of usual interstitial pneumonia (UIP), 2 cases (2.99%) of nonspecific interstitial pneumonia (NSIP), 2 cases (2.99%) of desquamative interstitial pneumonia (DIP), 1 case (1.49%) of respiratory bronchiolitis-associated interstitial lung disease (RB-ILD), 1 case (1.49%) of acute interstitial pneumonia (AIP), 1 case (1.49%) of lymphocytic interstitial pneumonia (LIP), and 1 case (1.49%) of cryptogenic organizing pneumonia (COP). Of the patients having pneumoconiosis with UIP, small opacities p and s were detected in 5 cases (8.47%) and 54 cases (91.53%), respectively; 1 case of large opacity were also found, accounting for 1.69%; the s-sized opacities were found more than the p-sized opacities (P<0.01). The chest X-ray of the pneumoconiosis patients with IIPs showed ground-glass opacities, reticulated nodules, and honeycombing as the main manifestations; the results of high resolution computed tomography (HRCT) in the pneumoconiosis patients with IIPs presented ground-glass opacities, honeycombing with traction bronchiectasis, interlobular septal thickening as the main changes. Ground-glass opacities, honeycombing with traction bronchiectasis, interlobular septal thickening were more obviously displayed in the HRCT scanning than in the chest X-ray (P<0.01). Conclusion The imaging features of pneumoconiosis with IIPs are of significant value for pneumoconiosis diagnosis and prognosis.
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