CAJ | 학술논문

目的回顾性分析隐原性机化性肺炎(COP)的系列CT表现特点及CT半定量分析激素治疗后的变化情况.方法对经病理确诊的13例COP患者的临床、病理和影像学资料进行回顾性分析.CT病变评价采用半定量方法计算,并进行皮质激素治疗前后病变程度变化分析.结果 CT上所有患者均表现为两肺野多个肺叶受累,下叶分布为主,沿支气管或胸膜下分布,CT最主要的表现是磨玻璃影(13例)及斑片状实变影(12例),病变范围占全肺的比例分别为13％、10％.所有患者确诊前抗炎治疗效果不明显或无效,确诊后均给予糖皮质激素治疗,2例完全吸收,8例好转,1例无明显改变,2例病变进展,病变以磨玻璃影(10例)及网格影(5例)为主,实变影4例,病变平均范围分别为19％、2％、1％.结论典型COP的CT表现具有特征性.经皮质激素治疗后复查CT大多数吸收或好转.病变半定量评价有助于临床医师更准确了解疾病的疗效.
목적 회고성분석은원성궤화성폐염(COP)적계렬CT표현특점급CT반정량분석격소치료후적변화정황.방법 대경병리학진적13례COP환자적림상、병리화영상학자료진행회고성분석.CT병변평개채용반정량방법계산,병진행피질격소치료전후병변정도변화분석.결과 CT상소유환자균표현위량폐야다개폐협수루,하협분포위주,연지기관혹흉막하분포,CT최주요적표현시마파리영(13례)급반편상실변영(12례),병변범위점전폐적비례분별위13％、10％.소유환자학진전항염치료효과불명현혹무효,학진후균급여당피질격소치료,2례완전흡수,8례호전,1례무명현개변,2례병변진전,병변이마파리영(10례)급망격영(5례)위주,실변영4례,병변평균범위분별위19％、2％、1％.결론 전형COP적CT표현구유특정성.경피질격소치료후복사CT대다수흡수혹호전.병변반정량평개유조우림상의사경준학료해질병적료효.
Objective To review the serial CT findings of cryptogenic organizing pneumonia(COP)and semiquantitatively analyze the changes after corticosteroid therapy.Methods The clinical and radiological features of 13 patients with COP confirmed by pathology were retrospectively collected and analyzed.The lung lesions extent on CT scans was estimated using semi-quantitative method.Changes of overall disease extent were evaluated by comparing the initial CT images and the follow-up CT scans after corticosteroid therapy.Results CT images of all cases revealed diffuse and bilateral lesions,mainly located in lower zone,distributed as predominantly subpleural and(or)along the bronchovascular bundle.The two most common manifestations of lung abnormality on initial scans were ground-glass opacity(GGO)(13 cases)and consolidation(12 cases),the average areas of which were 13％ and 10％ respectively.The treatment with antibiotics was ineffective.After treatment with corticosteroid,the lesions resolved completely in 2 patients ; the disease was decreased in extent in 8 patients ; and the lesion showed no change in extent in one patient,while the disease progressed in extent in 2 patients on follow-up CT.The most common CT findings were GGO(10 cases)and reticulation(5 cases),followed by consolidation(4 cases),the average areas of which were 19％,2％ and 1％ respectively.Conclusion The CT features of the patients with COP are characteristic.The most lesions resolved or improved after corticosteroid therapy on follow-up CT scans.The estimation of disease extent with semi-quantitative method is helpful for the clinicians to evaluate the therapeutic effect.