結(jié)節(jié)病影像學(xué)的特點(diǎn)課件

PulmonarySarcoidosis:TypicalandAtypicalManifestationsatHighResolutionCtwithPathologicCorrelationRecentAdvancesinSarcoidosisChest2019;139結(jié)節(jié)病CT典型和不典型表現(xiàn)結(jié)節(jié)病進(jìn)展OrganOrgan%KidneyRarel-2LymphNodes75-90NervousSystemSkinBe25-50asalmucosa鼻粘膜)5EndocrineglandsRareLarynx(喉)GanBonemarrow50-6nestingRare6090SystemSarcoidosisisamultisystemdisorderthatischaracterizedbynoncaseousepithelioidcellgranulomas,whichmayaffectalmostanyorgan結(jié)節(jié)病是一種以非干酪樣壞死的上皮細(xì)胞肉芽腫為特點(diǎn)的多系統(tǒng)疾病,幾乎可以累及所有器官asymptomaticItcommonlyimprovesorclearsupspontaneousl(自愈或好轉(zhuǎn)).Morehan2/3ofpeoplewithlungsarcoidosishavenosymptomsafter9About50%haverelapsesAbout10%developseriousdisability.Sarcoidosisofthelungisprimarilyaninterstitiallungdiseaseinwhichtheinflammatoryprocessinvolvesthealveoli,smallbronchi,andsmallbloodvessels節(jié)病原本是肺間質(zhì)性病變,累及肺泡,支氣管和小血管TypicalandAtypicalFeaturesofPulmonarySarcoidosisatHigh-ResolutionCTTypicalfeatures典型特征heal),bilateral,symmetric,andelldefined淋巴結(jié)増大,兩側(cè)對(duì)稱(chēng),境界清楚2Nodules:micronodules(2-4mmindiameter;welldefined,bilateral);macronodules(25mmindiameter,coalescing)3Lymphangiticspread:peribronchovascular,subpleural,interlobularseptal淋巴管播散,支氣管血管鞘,胸膜下,小葉間隔4Fibroticchanges:reticularopacities,architecturaldistortion,tractionbronchiectasis,bronchiolectasis,volumelossBilateralperihilaropacities纖維化改變,網(wǎng)狀陰影,肺結(jié)構(gòu)扭曲,牽拉性支擴(kuò),肺容積縮小,兩肺門(mén)旁致密影5Predominantupper-andmiddle-zonelocationsofparenchymalabnormalities中上肺為主Atypicalfeatures不典型表現(xiàn)1Lymphadenopathy:unilateral,isolated,anteriorandposteriormediastinal單側(cè)孤立前后縱隔淋巴結(jié)增大2Airspaceconsolidation:masslikeopacities,conglomeratemasses,solitarypulnonarylules,confluentalveolar(alveolarsarcoidpattern)肺泡實(shí)變:腫塊,實(shí)質(zhì)性結(jié)節(jié)Ground-glassopacities毛玻璃陰影4Linearopacities:interlobularseptalthickening,intralobularlinearopacities線狀陰影小葉間隔增厚小葉年線狀陰影Fibrocysticchanges:cysts,bullae,bl