高分辨率CT在特发性肺间质纤维化与结缔组织病相关间质性肺疾病鉴别诊断中的价值

目的探讨特发性肺间质纤维化（idiopathic pulmonary fibrosis，IPF）与结缔组织病相关间质性肺疾病（connective tissues disease—interstitial lung disease，CTD-ILD）高分辨率CT（high resolution CT，HRCT）征象的不同特点及应用价值。方法回顾性分析经HRCT扫描的17例IPF患者和36例CTD—ILD患者，根据磨玻璃密度影及实变影、蜂窝、小叶内间质增厚、牵拉支气管扩张、胸膜下曲线及小叶间隔增厚、胸膜增厚、胸腔积液、纵隔淋巴结增大的HRCT征象进行统计学分析。结果蜂窝是IPF的主要征象占64．7％，而CTD—ILD占16．7％（P=0．003）。磨玻璃影和实变影是CTD—ILD的主要征象占72．2％，而IPF占29．4％（P=0．000）。牵拉支气管扩张多见于IPF中占41．2％，CTD—ILD占13．9％（P=0．027）。结论虽然IPF的HRCT征象与CTD-ILD有许多相同或相似之处，但是IPF患者肺间质纤维化的进展程度明显超过CTD-ILD。

DIFFERENTIAL DIAGNOSTIC VALUE OF HIGH-RESOLUTION CT IN IDIOPATHIC PULMONARY FIBROSIS AND CONNECTIVE TISSUES DISEASE INTERSTITIAL LUNG DISEASE

Objective To evaluate the difference and the diagnostic value of high-resolution CT （HRCT） findings in patients with idiopathic pulmonary fibrosis （idiopathic pulmonary fibrosis, IPF）and connective tissues disease-interstitial lung disease （connective tissues disease-interstitial lung disease, CTD-ILD）. Methods Seventeen patients with IPF and 36 patients with CTD-ILD scanned by HRCT were reviewed retrospectively. Statistical analysis was conducted in ground-glass opacity and consolidation, honeycombing, interlobular interstitial thickening, traction bronchiectasis, subpleural curve and interlobular septal thickening, pleural thickening, pleural effusion and meditational lymph node enlargement. Results Honeycombing was the predominant pattern （64.7%） in IPF, while CTD-ILD only accounted for 16.7% （ P = 0. 003 ）. Ground-glass opacity and consolidation was the predominant pattern in CTD-ILD （72.2%）, while IPF accounted just for 29.4% （ P = 0. 000）. Traction bronchiectasis was 41.2% in IPF, but 13.9% in CTD-ILD （P = 0. 027 ）. Conclusion Although HRCT findings of IPF and CTD-ILD are similar and overlap considerably, but patients with IPF showed a tendency to more progressed fibrosis than patients with CTD-ILD.