CAJ | 학술논문

目的：探讨机化性肺炎伴脓肿的病理及螺旋 CT 特征以提高其诊断准确性。方法：对26例机化性肺炎伴脓肿的螺旋 CT 表现及病理特点进行回顾性分析，探讨病变的发生部位、形态、大小、边缘、密度及增强表现等影像学特点及病理特征。结果：26例中14例（54％）病灶位于胸膜下，呈团块、结节、不规则及楔形等多种形态，边缘多毛糙、模糊，18例（70％）边缘可见长、短毛刺，11例（42％）出现胸膜增厚或牵拉，14例 CT（54％）显示平扫病灶内出现单发或多发类圆形透亮区，3例（12％）出现形态不规则空洞。增强后平扫上显示为类圆形透亮区者均无强化，13例（50％）出现单发、多发类圆形无强化低密度区或蜂窝状改变，仅2例病灶呈环形强化；实变区域强化明显且有延迟强化趋势。病理上病灶内以局部肺实变、纤维母细胞或肌纤维母细胞长入肺泡腔内、细胞浸润、间质纤维化及局部或多灶性脓肿为特点。结论：多发小圆形透亮区或多发小圆形无强化区是机化性肺炎伴脓肿的特征性 CT 表现，当病变边缘不规则且出现空洞改变时，应考虑到机化性肺炎伴脓肿的可能。
목적：탐토궤화성폐염반농종적병리급라선 CT 특정이제고기진단준학성。방법：대26례궤화성폐염반농종적라선 CT 표현급병리특점진행회고성분석，탐토병변적발생부위、형태、대소、변연、밀도급증강표현등영상학특점급병리특정。결과：26례중14례（54％）병조위우흉막하，정단괴、결절、불규칙급설형등다충형태，변연다모조、모호，18례（70％）변연가견장、단모자，11례（42％）출현흉막증후혹견랍，14례 CT（54％）현시평소병조내출현단발혹다발류원형투량구，3례（12％）출현형태불규칙공동。증강후평소상현시위류원형투량구자균무강화，13례（50％）출현단발、다발류원형무강화저밀도구혹봉와상개변，부2례병조정배형강화；실변구역강화명현차유연지강화추세。병리상병조내이국부폐실변、섬유모세포혹기섬유모세포장입폐포강내、세포침윤、간질섬유화급국부혹다조성농종위특점。결론：다발소원형투량구혹다발소원형무강화구시궤화성폐염반농종적특정성 CT 표현，당병변변연불규칙차출현공동개변시，응고필도궤화성폐염반농종적가능。
Objective:To explore the pathology and spiral CT features of organizing pneumonia accompanied with ab-scess in order to improve its diagnostic accuracy.Methods:CT findings and pathological manifestations in 26 cases of organi-zing pneumonia with abscess were retrospectively analyzed to explore imaging characteristics such as disease location, shape,size,edge,density and enhancement and pathological features.Results:In 14 cases (54%)the lesions occurred in sub-pleural region.Lesions presented in a variety of forms such as lumps,nodules,irregular and wedge shape.The edges were al-most fuzzy or rough,with long and short spicules in 18 cases (70%)and 11 cases (42%)presented with pleural thickening or adhesion.14 cases (54%)showed one or more oval translucent areas and 3 cases (12%)showed irregular cavities on plain CT.Consolidation area showed intensive enhancement and tendency of delayed enhancement,among which 13 cases (50%)appeared as one or more oval areas without enhancement or honeycomb appearance,and only two cases showed ring enhancement.The pathological findings included partial lung consolidation,alveolar fibroblasts or myofibroblasts ingrowth, cell infiltration,interstitial fibrosis and local or multifocal abscesses.Conclusion:Multiple small round translucent areas or multiple small circular areas without enhancement were CT characterization of organizing pneumonia with abscess.Organi-zing pneumonia with abscess should be considered when the lesion presents with cavity and irregular edge.