课件：结节病CT典型和不典型型表现.ppt

Pulmonary Sarcoidosis: Typical and Atypical Manifestations at High- Resolution CT with Pathologic Correlation Recent Advances in Sarcoidosis Chest 2011;139; 结节病CT典型和不典型表现 结节病进展 Organ Lung Pleura Lymph Nodes Skin Eye Nasal Mucosa（鼻粘膜） Larynx（喉） Bone Marrow Spleen Liver % 90 1-5 75-90 25 25 20 5 15-40 50-60 60-90 Organ Kidney Calcium Metabolism Nervous System Bone Joints Heart Endocrine Glands Parotid Gland Gastrointestinal System % Rare 1-2 5 5 25-50 5 Rare 10 Rare Sarcoidosis is a multisystem disorder that is characterized by noncaseous epithelioid cell granulomas, which may affect almost any organ. 结节病是一种以非干酪样坏死的上皮细胞肉芽肿为特点的多系统疾病，几乎可以累及所有器官。 Sarcoidosis may be asymptomatic or chronic. It commonly improves or clears up spontaneously（自愈或好转）. More than 2/3 of people with lung sarcoidosis have no symptoms after 9 years. About 50% have relapses. About 10% develop serious disability. Sarcoidosis of the lung is primarily an interstitial lung disease in which the inflammatory process involves the alveoli, small bronchi, and small blood vessels. Typical and Atypical Features of Pulmonary Sarcoidosis at High-Resolution CT Typical features 1 Lymphadenopathy: hilar, mediastinal (right paratracheal), bilateral, symmetric, and well defined 2 Nodules: micronodules (2–4 mm in diameter; well defined, bilateral); macronodules (≥5 mm in diameter, coalescing) 3 Lymphangitic spread: peribronchovascular, subpleural, interlobular septal 4 Fibrotic changes: reticular opacities, architectural distortion, traction bronchiectasis, bronchiolectasis, volume loss Bilateral perihilar opacities 5 Predominant upper- and middle-zone locations of parenchymal abnormalities 结节病原本是肺间质性病变，累及肺泡，支气管和小血管 淋巴结增大，两侧对称，境界清楚 大小结节 淋巴管播散，支气管血管鞘，胸膜下，小叶间隔 纤维化改变，网状阴影，肺结构扭曲，牵拉性支扩，肺容积缩小，两肺门旁致密影 中上肺为主 典型特征 Atypical features 1 Lymphadenopathy: unilateral, isolated, anterior and posterior mediastinal 2 Airspace c