ISSN 1004-4140
CN 11-3017/P

儿童弥漫性肺淋巴管瘤病CT表现

Pediatric Diffuse Pulmonary Lymphangiomatosis: CT Characteristics

  • 摘要: 目的:探讨儿童弥漫性肺淋巴管瘤病的特征性CT表现,提高诊断符合率。方法:回顾性分析经临床、影像表现及病理活检确诊为弥漫肺淋巴管瘤病13例患儿影像学资料,其中女孩6例,男孩7例,平均年龄5.8岁,13例患儿均行CT平扫及增强检查。结果:弥漫性肺淋巴管瘤病的特征性CT表现为:①纵隔及肺门、支气管血管束周围、小叶间隔等多部位受累;②纵隔增厚的软组织与肺门、支气管血管束周围软组织增厚相延续;③纵隔内软组织影密度低,增强后未见强化,对于头臂大血管无压迫、推移改变;④肺门增厚及支气管血管束周围软组织增厚、小叶间隔光滑增厚大部分累及双侧,少数同时累及一侧;⑤胸膜增厚或胸腔积液;⑥脾脏受累多见;⑦颈部及或腋下淋巴结肿大并密度减低;⑧椎体数个或单个密度减低。实验室检查合并血小板减低和/或DIC,考虑为卡波西样肺淋巴管瘤病。结论:儿童弥漫性肺淋巴管瘤病CT表现具有较高的特异性,结合发病年龄及临床实验室检查,可明显提高该病的诊断符合率。

     

    Abstract: Objective: To explore the typical CT features of diffuse pulmonary lymphangiomatosis in children and improve the diagnostic accuracy. Methods: The radiologic data of 13 children with diffuse pulmonary lymphangiomatosis confirmed by clinical, imaging and pathological biopsy were reviewed retrospectively, including 6 girls and 7 boys, with an average age of 5.8 years. All the 13 cases underwent CT plain scan and enhanced examination. Results: The characteristic CT findings of diffuse pulmonary lymphangiomatosis in this group were as follows: (1) Mediastinum and hilum, peribronchovascular, interlobular septa were involved; (2) The thickening of soft tissue in mediastinum continued with the thickening of soft tissue around hilum and bronchovascular; (3) The soft tissue density in the mediastinum was low, no enhancement was observed under contrast, and there was no compression or shift in the brachiocephalic great vessels; (4) Hilar thickening, smooth thickening of soft tissue around bronchovascular and interlobular septa, most of which involved both sides of the lung, and a few involved one side at the same time; (5) Pleural thickening or pleural effusion; (6) Spleen involvement is common; (7) Cervical and or axillary lymph node enlargement and density reduction; (8) The density of several or single vertebrae wasreduced. Laboratory examination with thrombocytopenia and/or DIC was considered Kaposiform lymphangiomatosis. Conclusion: CT findings of diffuse pulmonary lymphangioma lymphangiomatosis in children show high specificity, when combined with the age of onset and clinical laboratory examinations, can significantly improve the diagnostic coincidence rate of the disease.

     

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