Hypothesis on the evolution of cavitary lesions in nontuberculous mycobacterial pulmonary infection: thin-section CT and histopathologic correlation

OBJECTIVE: The objectives of our study were to evaluate the thin-section CT findings of the cavitary form of nontuberculous mycobacterial pulmonary infection and correlate these imaging findings with the histopathologic findings concerning the development of bronchiectasis and of centrilobular nodules and cavitary lesions. MATERIALS AND METHODS: We retrospectively reviewed thin-section CT scans (2.5-mm collimation, both axial and coronal reformation images) of 24 cases (male-female ratio, 13:11; mean age, 61 years; age range, 43-82 years) of the cavitary form of culture-proven Mycobacterium avium-intracellulare complex pulmonary infection including two cases with lobectomy specimens. Any changes in CT findings detected on the follow-up CT scans that were available for seven patients (follow-up interval, 6-24 months; mean, 12 months) were also assessed. RESULTS: Thin-section CT findings were bronchiectasis (24/24 patients, 100%), a patent bronchus running into a cavitary lesion (the "feeding bronchus" appearance) (18/24, 75%), nodules less than 10 mm (17/24, 71%), centrilobular nodules (17/24, 71%), nodules of 10-30 mm (13/24, 54%), peribronchial nodules (8/24, 33%), lobular consolidation (6/24, 25%), bronchial wall thickening (4/24, 17%), and consolidation (2/24, 8%). Two lobectomy specimens showed large cavitary consolidations with the feeding bronchus appearance on pathologic specimens. In two patients, small peribronchial nodules had changed into cavitary nodules with the feeding bronchus appearance on follow-up CT, which represented inflamed focal cystic bronchiectasis. CONCLUSION: In the cavitary form of M. avium-intracellulare complex pulmonary infection, the feeding bronchus appearance is another very frequent thin-section CT finding. This appearance may suggest that peribronchial nodules of M. avium-intracellulare complex infection evolve into inflamed focal cystic bronchiectasis manifesting as cavitary lesions.     

Computed tomography features of primary pulmonary non-Hodgkin's lymphoma.

AIM: To characterize computed tomography (CT) features of primary pulmonary lymphoma (PPL). METHODS: The CT films of six patients (five men, one woman; 63.2 +/- 14.5 years) with low grade non-Hodgkins PPL were evaluated for alveolar opacities (lobar consolidation, masses or nodules, and ill-defined consolidations), peribronchial disease or bronchial wall thickening, mediastinal nodes and pleural effusion. RESULTS: Multilobar bilateral, multilobar unilateral, and unilobar unilateral involvement were present in three, one and two cases respectively. CT features were: ill-defined mainly subpleural consolidations (n = 4), mass-like consolidation (n = 1), lobar consolidation (n = 1), and pleural effusion (n = 1). Minor peribronchial disease was seen in two patients, heterogeneous enhancement in four patients, and CT-angiogram sign in one patient. There were no lymphadenopathy or lung nodules. Although the pleura were inseparable from subpleural disease, pleural enhancement was noted on magnetic resonance imaging (MRI) of a patient with lobar lymphoma. CONCLUSION: PPL is characterized by ill-defined alveolar opacities that are usually multifocal. Peribronchial disease, proximal bronchiectasis and positive CT-angiogram sign are ancillary features. MRI may be useful in further evaluation with respect to pleural or chest wall involvement.     

Organizing pneumonia: perilobular pattern at thin-section CT

PURPOSE: To describe the appearance and frequency of a perilobular pattern at thin-section computed tomography (CT) in patients with organizing pneumonia. MATERIALS AND METHODS: Thin-section CT scans of 21 consecutive patients with cryptogenic organizing pneumonia were retrospectively reviewed. Two thoracic radiologists in consensus recorded the presence and distribution of the CT abnormalities (consolidation, ground-glass opacification, nodules, bandlike opacities, interlobular septal thickening, and findings of fibrosis), with a particular focus on the presence and predominant location of the perilobular pattern, that is, a poorly defined arcadelike or polygonal appearance. RESULTS: The perilobular pattern was present in 12 (57%) of 21 patients, 10 of whom had five or more perilobular opacities. Other CT features were consolidation (20 patients, 95%), which was predominantly a subpleural and/or peribronchial distribution in 17 patients, and ground-glass opacification (18 patients, 86%). Bandlike opacities and interlobular septal thickening were observed in four patients and one patient, respectively. The perilobular pattern abutted the pleural surface in 10 of 12 patients and was surrounded by aerated lung parenchyma in 11 of 12 patients. There was no obvious relationship between perilobular opacities and CT findings indicative of established fibrosis. CONCLUSION: A perilobular pattern was present in more than half of the patients, along with the expected thin-section CT features of organizing pneumonia.     

Amyloidosis and lymphoproliferative disease in Sjögren syndrome: thin-section computed tomography findings and histopathologic comparisons

OBJECTIVE: To describe the thin-section computed tomography (CT) findings of Sjogren syndrome accompanying pulmonary amyloidosis and lymphoproliferative disease and to compare these with histopathologic findings. SUBJECTS AND METHODS: The thin-section CT findings of 5 women (age range: 42-59 years, mean age=50 years) with primary Sjogren syndrome accompanying pulmonary amyloidosis and lymphoproliferative disease were reviewed retrospectively by 2 chest radiologists, and decisions on findings were reached by consensus. The pathologic specimens of parenchymal lesions (nodules, dense consolidation, and cystic lesion at CT) obtained using video-assisted thoracoscopic surgery were studied to compare with the thin-section CT findings. RESULTS: Nodules, observed in all 5 patients, were variable in size and ranged from 3 to 24 mm (mean=9.9 mm) in diameter, with lobulated or irregular margins. Nodular calcifications were present in 3 patients. Cysts, which also were observed in all patients, ranged from 4 to 45 mm (mean=18.6 mm) in diameter, with a thin (1-2 mm) or no visible wall. Multiple cysts were observed, especially in the distal portion of narrowed bronchioles. Nodules and cysts showed a random distribution. Mild bronchial wall thickening with bronchial dilatation was seen in all patients, ground-glass opacities were seen in 3, and consolidation was seen in 1. Nodules, consolidation, and bronchial wall thickening at CT were caused histopathologically by the interstitial and peribronchiolar deposition of mixed amyloid and lymphoproliferative cells. Cysts lined with respiratory epithelium contained amyloid deposition and lymphoproliferative cells in their walls. CONCLUSION: Sjogren syndrome accompanying pulmonary amyloidosis and lymphoproliferative disease manifests as multiple, large, thin-walled cysts; multiple nodules; parenchymal opacity; and bronchiectasis. These findings are caused by the interstitial or peribronchial infiltration of mixed amyloid and lymphoproliferative cells.     

Near drowning: thin-section CT findings in six patients

PURPOSE: The purpose of this study was to assess the thin-section CT findings of near drowning in six patients. METHOD: Thin-section (1 mm collimation) CT scans of six patients who experienced near drowning were retrospectively analyzed. The CT scans were performed 0-5 days (median 1 day) after near drowning. RESULTS: Thin-section CT findings included bilateral patchy or diffuse areas of ground-glass attenuation (n = 6) with geographic pattern (n = 3) and fine intralobular reticular opacities ("crazy-paving" appearance) (n = 3), ill-defined centrilobular nodules (n = 4), and air-space consolidation (n = 1). Distribution of ground-glass attenuation was predominantly central (n = 4) or diffuse (n = 2). Interstitial pulmonary emphysema and pneumomediastinum were present in two patients. CONCLUSION: The thin-section CT findings of near drowning consist of ground-glass opacities with or without associated reticular opacities and centrilobular nodules.     

Pleuropulmonary paragonimiasis: radiologic findings in 71 patients.

Pleuropulmonary paragonimiasis is a disease caused by lung flukes characterized by migration of a juvenile worm in the early stage and by formation of cysts around the worm later on. The purpose of this study was to describe the radiologic manifestations of pleuropulmonary paragonimiasis, with special emphasis on the worm cyst and worm migration track. We retrospectively studied 71 patients who had evidence of pleuropulmonary paragonimiasis on chest radiographs (n = 71) and CT scans (n = 17). The diagnosis was based on the detection of eggs or on positive antibody tests. On chest radiographs, 59 patients (83%) had pulmonary lesions and 43 patients (61%) had pleural lesions. Pulmonary findings included patchy air-space consolidation (n = 37) with or without cystic changes; ring shadows (n = 16); and peripheral linear opacities (n = 29), which were more prominent in patients with pleural effusion. Twelve patients (17%) had bilateral pleural effusions or pneumothoraces. On CT scans, round low-attenuation cystic lesions (5-15 mm), filled either with fluid (n = 5) or gas (n = 5), were characteristically seen within the consolidation. Peripheral linear opacities seen on radiographs were suggestive of worm migration tracks on CT scans. CT may reveal an intracystic worm. Although the findings vary depending on the stage of the disease, findings on chest radiographs are usually typical of paragonimiasis. CT provides more specific information about the worm cyst and the worm migration track.     

Intrapulmonary lymph nodes: computed tomography findings with histopathologic correlations

We retrospectively assessed the computed tomography (CT) features of 31 intrapulmonary lymph nodes (IPLNs) with histopathologic correlations. CT scans revealed that the IPLNs are located in the subpleural region, frequently below the level of the carina, and angular in shape. Most of the IPLNs are solid in texture but occasionally present with a ground-glass appearance. For pleura-attached and pleura-separated IPLNs, one or more and 3 or more linear opacities extending from the nodules can be identified, respectively. Histologically, the IPLNs are located either at the junction of the pleura and lung lobules or at the junction of adjacent lung lobules.     

Lung diseases in patients with common variable immunodeficiency: chest radiographic, and computed tomographic findings

OBJECTIVE: To evaluate chest radiographic and computed tomographic (CT) findings of lung disease related to common variable immunodeficiency. METHODS: Thirty-five chest radiographs and 30 CT scans of 46 patients were assessed. Lung parenchymal abnormalities that were evaluated included airspace consolidation, ground-glass attenuation, nodules, bronchiectasis, and air trapping. RESULTS: On CT, ground-glass attenuation and nodules were the most frequent findings, observed in 60% (n = 18/30) and 83% (n = 25/30), respectively. Three major CT patterns were identified: airway disease (n = 13), nodules (n = 8), and parenchymal opacification (n = 6). All 13 patients with airway disease showed centrilobular opacities. One patient with peribronchial nodules showed lymphoid interstitial pneumonia, and 1 with randomly distributed nodules showed noncaseating granulomas. Patients with a CT pattern of parenchymal opacification showed lower lung predominance; surgical biopsies showed organizing pneumonia in 1 patient and lymphoid interstitial pneumonia with nonnecrotizing granulomas in another. CONCLUSIONS: Common variable immunodeficiency is associated with 3 major CT patterns: airway disease, nodules, and parenchymal opacification.     

Thoracic manifestation of Wegener's granulomatosis: CT findings in 30 patients

Our objective was to describe the CT findings of thoracic Wegener's granulomatosis. At presentation, both conventional and thin-section CT scans were available in 30 patients with Wegener's granulomatosis. Serial CT scans (range of intervals: 1–25 months, mean 4.5 months) were available in 20 patients. The initial and follow-up CT scans were analyzed retrospectively by two observers in terms of pattern and extent of parenchymal and airway lesions. Positive CT findings were seen in 29 of 30 (97%) patients at initial presentation. The most common pattern was nodules or masses seen in 27 of 30 (90%) patients. They were multiple in 23 of 27 (85%) patients, bilateral in 18 (67%), subpleural in 24 (89%), and peribronchovascular in 11 (41%) in distribution. Bronchial wall thickening in the segmental or subsegmental bronchi was seen in 22 (73%) patients. Large airways were also abnormal in 9 (30%) patients. Patchy areas of consolidation and ground-glass opacity were seen in 7 (23%) patients, respectively. In 17 of 20 (85%) patients in whom follow-up CT scans were available, the parenchymal or airway lesion showed complete or partial improvement with treatment. The CT findings of Wegener's granulomatosis, although multiple and variable, consist mainly of bilateral subpleural or peribronchovascular nodules or masses and bronchial wall thickening in the segmental or subsegmental bronchi. Parenchymal and airway lesions improve with treatment in most patients. Electronic Publication     

Transient radiographic progression during initial treatment of pulmonary tuberculosis: CT findings

PURPOSE: A study was undertaken to describe the thin-section CT features of transient radiographic progression during initial treatment of active pulmonary tuberculosis. METHOD: The CT scans of 13 patients who developed transient radiographic progression during initial treatment of pulmonary tuberculosis were evaluated and compared with those of 10 patients with true progression of pulmonary tuberculosis. Two patients underwent transbronchial lung biopsy for pathologic evaluation of new lesion. RESULTS: Eight patients had increased opacity at the site of their original lesion, whereas five had new opacities elsewhere: ipsilateral (n = 3) or contralateral (n = 1) to the original lesion or both (n = 1). Relatively extensive areas of ground-glass attenuation were concomitantly depicted in three of the eight patients with progression in the area of the original lesion. In those with progression ipsilateral or contralateral to the lesion, the character of the new lesions was ground-glass opacity and/or consolidation mainly in the subpleural region. Transbronchial lung biopsy specimens obtained from two patients showed intraluminal organizing exudates and thickened alveolar septa with lymphocyte infiltration, whereas the dominant CT findings of true progression of pulmonary tuberculosis were nodules (n = 8) or centrilobular nodules (n = 7). CONCLUSION: Thin-section CT may be useful to differentiate transient radiographic progression from true progression of pulmonary tuberculosis.     

Thoracic paracoccidioidomycosis: radiographic and CT findings

Paracoccidioidomycosis (PCM) is the most common systemic mycosis in Latin America. Although most cases occur in developing countries, recent immigration patterns and an increase in travel have led to a growing number of PCM cases in the United States and Europe. PCM is caused by the dimorphic fungus Paracoccidioides brasiliensis, and the chronic form may progress to severe pulmonary involvement. Several radiologic patterns have been described for pulmonary PCM, including linear and reticular opacities, variable-sized nodules, patchy ill-defined opacities, airspace consolidation, and cavitary lesions. Fibrosis and paracicatricial emphysema are common associated findings. Chest computed tomography (CT) is the method of choice for evaluating pulmonary PCM, with the most common CT findings being ground-glass attenuation, consolidation, small or large nodules, masses, cavitations, interlobular septal thickening, emphysema, and fibrotic lesions. PCM is also an important cause of the "reversed halo" sign at high-resolution CT and should be considered in the differential diagnosis. Awareness of the multiple radiologic manifestations of PCM as well as its epidemiologic and clinical characteristics may permit early diagnosis and initiation of specific treatment, thereby reducing associated morbidity and mortality.     

The computed tomographic findings of pulmonary epithelioid hemangioendothelioma

Purpose

The aim of this study is to analyse the computed tomographic (CT) findings of pulmonary epithelioid haemangioendothelioma (EHE).

Materials and methods

The CT features and clinical presentations of six patients (five women, one man; mean age, 53 years) with pathology-proven pulmonary EHE were reviewed. Noncontrast CT images were available for three patients and enhanced CT images for three patients. The image characteristics included the number of tumours, tumour location and size, tumour margins, the presence of calcification/necrosis/cavity, the presence of perivascular location, the presence of pleural lesions, tumour homogeneity at contrast-enhanced CT, tumour enhancement relative to the adjacent muscle and the presence of extrapulmonary lesions.

Results

Multiple nodules/masses with irregular margin were shown in all cases, and reticulonodular opacities and ground-glass opacities were found in one case. Overall, the six cases showed 178 nodules/masses, 90 % (160/178) of which were <1 cm in diameter. The average size of the largest nodules/masses in each case was 2.7 cm. The nodules/masses were mostly (93 %, 166/178) located in the subpleural region (<2 cm from the pleura). A total of 48 % (86/178) of nodules/masses showed punctate calcification in four of six cases. All nodules/masses showed perivascular location. Pleural indentation was shown in all cases, as well as pleural-thickening in five cases and pleural effusion in two cases. On contrast-enhanced CT, EHE showed a mildly heterogeneous hyperdense appearance.

Conclusions

With predilection for subpleural and perivascular location, typical pulmonary EHE appears as multiple irregular nodules with punctate calcification and pleural indentation.     

Newly diagnosed pulmonary sarcoidosis in HIV-infected patients

PURPOSE: To determine the radiologic and clinical features of newly diagnosed pulmonary sarcoidosis in human immunodeficiency virus (HIV)-infected patients. MATERIALS AND METHODS: Ten HIV-infected patients (seven women, three men; age range, 26-66 years; mean age, 37 years) with newly diagnosed sarcoidosis between 1989 and 1997 were retrospectively identified. Charts were reviewed for the interval between the two diagnoses, CD4 cell count, signs or symptoms, angiotensin-converting enzyme level, and initiation of highly active antiretroviral therapy (HAART). Chest radiographs (n = 10) and computed tomographic (CT) scans (n = 8) were assessed for lymphadenopathy, pulmonary nodules, focal consolidation, reticular or granular opacities (thickened interlobular septa and ground-glass opacities at CT), cysts or cavities, and fibrosis. RESULTS: Mean interval between the two diagnoses was 3 years. Mean CD4 cell count was 213 cells per cubic millimeter. When sarcoidosis was diagnosed, eight patients had pulmonary signs or symptoms. The angiotensin-converting enzyme level was elevated in five of six patients; two developed sarcoidosis after beginning HAART. Chest radiographs revealed lymphadenopathy, pulmonary nodules, focal consolidation, reticular opacities, granular opacities, and cysts or cavities. Chest CT scans revealed lymphadenopathy, nodules, thickened interlobular septa, focal consolidation, reticular opacities, ground-glass opacities, and cysts or cavities. There was no relationship between the radiographic findings of sarcoidosis and the CD4 cell count. CONCLUSION: The radiologic features of newly diagnosed sarcoidosis in HIV-infected patients resemble the findings of sarcoidosis in non-HIV-infected patients. In HIV-infected patients receiving HAART, sarcoidosis may be a manifestation of disease related to restoration of the immune system.     

Follicular bronchiolitis: thin-section CT and histologic findings.

PURPOSE: To evaluate the thin-section computed tomographic (CT) findings of follicular bronchiolitis and compare them with the histologic findings. MATERIALS AND METHODS: Thin-section CT scans obtained in 12 patients (age range, 24-77 years; mean age, 47 years) with follicular bronchiolitis proved at open lung biopsy were reviewed by two observers. Underlying conditions included rheumatoid arthritis (n = 8), mixed collagen vascular disorders (n = 2), autoimmune disorder (n = 1), and acquired immunodeficiency syndrome (n = 1). All patients had thin-section CT scans (1.0-1.5-mm collimation, 11 patients; 3.0-mm collimation, one patient; high-spatial-frequency reconstruction algorithm) obtained at 10-mm intervals through the chest. RESULTS: The main CT findings included bilateral centrilobular (n = 12) and peribronchial (n = 5) nodules. All 12 patients had nodules smaller than 3 mm in diameter; six patients also had nodules 3-12 mm in diameter. Areas of ground-glass opacity were present in nine (75%) patients. Histologically, all patients had lymphoid hyperplasia along the bronchioles; eight had peribronchiolar lymphocytic infiltration. CONCLUSION: The cardinal CT feature of follicular bronchiolitis consists of small centrilobular nodules variably associated with peribronchial nodules and areas of ground-glass opacity.     

Interstitial lung disease in association with polymyositis-dermatomyositis: long-term follow-up CT evaluation in seven patients

PURPOSE: To determine the long-term follow-up computed tomographic (CT) findings of interstitial lung disease associated with polymyositis-dermatomyositis. MATERIALS AND METHODS: CT scans in seven patients with interstitial lung disease and associated polymyositis-dermatomyositis were evaluated retrospectively. Six patients underwent sequential CT (follow-up range, 2-8 years; mean, 4.3 years). Histologic confirmation of pulmonary involvement was available in five patients. RESULTS: The predominant finding on the initial CT scans in four patients was subpleural consolidation, which corresponded to bronchiolitis obliterans organizing pneumonia with or without coexistent chronic eosinophilic pneumonia. In most cases, consolidation improved with use of corticosteroid and/or immunosuppressive therapy; in two patients, however, consolidation evolved into honeycombing. In one patient, diffuse areas of ground-glass opacity and consolidation appeared rapidly during illness; this patient died of sudden, rapid deterioration. In one patient with subpleural linear opacities, parenchymal abnormalities slowly progressed, and linear opacities had evolved into honeycombing at 8-year follow-up. In one patient with histologically proved organizing diffuse alveolar damage, bilateral patchy areas of ground-glass opacity and consolidation were seen. In one patient, subpleural bands changed to subpleural lines on sequential CT scans. CONCLUSION: CT provides an excellent demonstration of the lung changes in patients with interstitial lung disease and associated polymyositis-dermatomyositis.     

Pulmonary lesions associated with visceral larva migrans due to Ascaris suum or Toxocara canis: imaging of six cases

OBJECTIVE: The objective of our study was to evaluate chest radiographic and CT findings of patients with pulmonary lesions associated with visceral larva migrans due to Ascaris suum or Toxocara canis. CT investigation was focused on the location, size, contour, and internal features of the lesions; migration of lesions; mediastinal lymphadenopathy; and pleural effusion. CONCLUSION: Pulmonary visceral larva migrans appears on CT as multifocal subpleural nodules with halo or ground-glass opacities and ill-defined margins.     

炎症型细支气管肺泡细胞癌与肺炎的CT征象对比分析

目的探讨炎症型细支气管肺泡细胞癌（BAC）与肺炎的CT征象特点,提高对两种疾病的鉴别诊断水平。方法回顾性对比分析12例炎症型BAC及20例肺炎的CT征象。结果炎症型BAC主要分布于肺外带胸膜下,CT表现为磨玻璃样密度背景下的斑片状实变影,常伴空泡征、病理性含气支气管征及血管征、＂卫星＂腺泡结节、胸膜凹陷征及分叶征,一般无胸膜增厚;而肺炎常分布于中下肺叶,少见磨玻璃样密度、空泡征、病理性含气支气管征、分叶征及胸膜凹陷征,无＂卫星＂腺泡结节,慢性肺炎常可见邻近胸膜增厚。炎症型BAC与肺炎均不易引起肺门及纵隔淋巴结肿大。结论 CT检查对炎症型BAC与肺炎的鉴别诊断可提供重要依据。     

Pulmonary fat embolism syndrome: CT findings in six patients

PURPOSE: Our purpose is to describe the CT findings in pulmonary fat embolism syndrome (FES). METHOD: Chest radiographs and CT scans of six patients with pulmonary FES were reviewed. Initial and follow-up CT findings were noted, and the extent of CT abnormalities was correlated with partial pressure of arterial oxygen (PaO2). RESULTS: Focal areas of consolidation or ground-glass opacity and nodules were seen in all patients, predominantly in the upper lobes of the lungs. Association between these opacities and pulmonary vessels was indicated in three patients. In the lower lobes of all patients, gravity-dependent opacities predominated. Diffuse ground-glass opacity was noted in five patients. Follow-up CT scans showed rapid improvement in three patients, but the gravity-dependent opacity progressed. The extent of CT abnormalities correlated positively with PaO2 (r = 0.8, p < 0.05). CONCLUSION: CT findings reflect the pathophysiology of this syndrome, which differs from that of simple capillary permeability pulmonary edema.     

Pulmonary histiocytosis X: evaluation with high-resolution CT

Eighteen patients with pulmonary lesions of histiocytosis X were studied with high-resolution computed tomography (CT). Thin-walled cysts were found in all but one patient. The other abnormalities included nodules (n = 14), cavitated nodules (n = 3), thick-walled cysts (n = 7), reticulation (n = 4), ground-glass opacities (n = 4), and irregular interfaces (n = 4). The lesions were most often diffuse (n = 16), with a topographic predominance in the upper or middle lung zones in nine patients. Comparison of CT scans and chest radiographs shows that small and large cysts and micronodules are better detected with CT. Comparison of abnormalities found in patients in the early and late stages of the disease, as well as the evolution observed in one case, suggests that CT patterns progress from nodules to cavitated nodules and thick-walled cysts to cysts to confluent cysts.     

结缔组织病肺间质病变的高分辨CT表现及临床意义

目的探讨结缔组织病肺间质病变的高分辨CT表现及临床意义。方法分析26例结缔组织病合并肺间质病变的高分辨CT表现及临床意义。结果26例结缔组织病合并肺间质病变HRCT表现为磨玻璃影、小叶间隔增厚、胸膜下线状影、支气管血管束周围间质增厚、小叶内间质增厚、胸膜下间质增厚、界面征、牵引性支气管扩张、肺小叶变形、蜂窝状影等征象,经糖皮质激素及免疫抑制剂治疗后,部分病例磨玻璃影明显吸收,小叶间隔增厚、支气管血管束周围间质增厚、小叶内闻质增厚有所减轻,但蜂窝状影、牵引性支气管扩张、肺小叶变形无改变。结论磨玻璃影、小叶间隔增厚、胸膜下线状影、支气管血管束周围间质增厚、小叶内间质增厚、胸膜下间质增厚、以及界面征等征象可能为可逆改变,而牵引性支气管扩张、肺小叶变形、蜂窝状影为不可逆改变。结缔组织病合并肺间质改变的高分辨cT表现对早期诊断及临床治疗有重要意义。