Asbestosis: high-resolution CT-pathologic correlation.
Asbestosis: high-resolution CT-pathologic correlation.
复制标题
石棉沉滞症：高分辨率 CT 病理相关性。
作者：
Masanori Akira;Satoru Yamamoto;K. Yokoyama;N. Kita;Kenji Morinaga;T. Higashihara;Takenori Kozuka
高分辨率计算机断层扫描（HRCT）进行了7个膨胀和固定死后肺从7石棉暴露患者病理证实石棉肺。在体外HRCT上观察到的实质异常包括小叶内线条增厚（n = 7）、小叶间线条增厚（n = 7）、胸膜基底阴影（n = 7）、实质纤维带（n = 5）、胸膜下曲线阴影（n = 4）、磨玻璃样外观（n = 4）、牵引性支气管扩张（n = 4）和蜂窝样改变（n = 2）。组织学显示小叶内线增厚是由于细支气管周围纤维化。小叶间线增厚主要是由于4个肺的小叶间纤维化增厚和3个肺的水肿。胸膜下肺区域的细支气管周围纤维化最严重，形成曲线阴影和胸膜不透明区域。一些胸膜下纤维化沿支气管血管鞘向近端沿着延伸，形成带状病变。HRCT上的毛玻璃样表现是由于纤维化或水肿导致的轻度肺泡壁和小叶间隔增厚。死后HRCT表现与生前相似，并与石棉肺的病理结果相关。
High-resolution computed tomography (HRCT) was performed in seven inflated and fixed postmortem lungs from seven asbestos-exposed patients with pathologically proved asbestosis. The parenchymal abnormalities seen at in vitro HRCT included thickened intralobular lines (n = 7), thickened interlobular lines (n = 7), pleural-based opacities (n = 7), parenchymal fibrous bands (n = 5), subpleural curvilinear shadows (n = 4), ground-glass appearance (n = 4), traction bronchiectasis (n = 4), and honeycombing (n = 2). The thickened intralobular lines were shown histologically to be due to peribronchiolar fibrosis. Thickened interlobular lines were due mainly to interlobular fibrotic thickening in four lungs and edema in three. The peribronchiolar fibrosis was most severe in the subpleural lung regions, creating curvilinear line shadows and pleural-based areas of opacity. Some subpleural fibrosis extended proximally along the bronchovascular sheath to create bandlike lesions. Areas of ground-glass appearance on HRCT scans were shown to be the result of mild alveolar wall and interlobular septal thickening due to fibrosis or edema. Postmortem HRCT findings were similar to premortem HRCT findings and correlated well with the pathologic findings of asbestosis.