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目的评价胸部高分辨率CT诊断结缔组织病所致肺间质病变(interstitial lung disease associated with connective tissuediseases,CTD-ILD)的价值。方法回顾性分析26例临床确诊CTD-ILD患者的X线胸片、常规CT及高分辨率CT影像资料。结果高分辨率CT检出CTD-ILD 17例(65.4%),常规CT检出9例(34.6%),X线胸片检出4例(15.4%),高分辨率CT检出率高于常规CT(χ2=6.125,P=0.013)和X线胸片(χ2=10.286,P=0.001);CTD-ILD患者X线胸片主要表现为网状影、蜂窝状影、胸膜增厚及胸腔积液;早期CTD-ILD患者高分辨率CT主要表现为磨玻璃影或片状浸润影,随病情进展出现小叶间隔增厚、胸膜下线、网格状影,病变晚期呈蜂窝状改变;常规CT显示磨玻璃影、小叶间隔增厚不如高分辨率CT。结论高分辨率CT可发现肺部、胸膜的细微病变,是早期发现CTD-ILD的有效方法。
Objective To evaluate the value of high resolution chest CT in the diagnosis of interstitial lung disease associated with connective tissue lesions (CTD-ILD). Methods A retrospective analysis of 26 cases of clinically diagnosed CTD-ILD patients with X-ray, conventional CT and high resolution CT image data. Results CTD-ILD was detected in 17 cases (65.4%) by high-resolution CT, 9 cases (34.6%) by conventional CT, 4 cases (15.4%) by X-ray and high-resolution CT Conventional CT (χ2 = 6.125, P = 0.013) and X-ray (χ2 = 10.286, P = 0.001); X-ray chest CTD-ILD patients mainly showed reticular shadow, cellular shadow, pleural thickening and pleural Effusion; early CTD-ILD patients with high resolution CT showed mainly ground glass shadow or patchy infiltration shadow, with the progression of the disease showed interlobular septa thickening, subpleural line, grid-like shadow, late lesions were honeycombed changes; conventional CT showed ground glass, thicker interlobular septa than high-resolution CT. Conclusion High-resolution CT can detect the lung and pleura of small lesions, early detection of CTD-ILD is an effective method.