摘要
目的分析胸部CT特征与IgG4相关性疾病(IgG4-RD)的关系。方法对77例确诊的IgG4-RD患者的临床资料和胸部CT进行回顾性分析,包括肺实质型病变、肺间质型病变、胸部淋巴结增大、胸膜腔病变,以及罕见的食管和胸椎病变。结果共有40例以肺实质型病变为主,其中包括14例实性大结节/肿块型和26例多发小结节。另外,31例以间质型病变为主,包括18例中轴间质型和13例周围间质型。还有6例属于纵隔型病变,其中包括1例后纵隔纤维化、1例胸椎受累和1例食管受累,其他3例属于其他类型。此外,48例患者出现胸部淋巴结增大,10例患者出现胸腔积液,17例患者出现胸膜增厚。大多数患者(65/77)采用糖皮质激素单独治疗或联合使用免疫抑制剂。而38例患者在治疗后接受了CT检查,其中24例病灶吸收并且数量减少。结论IgG4-RD在胸部CT中表现为肺实质型、肺间质型和纵隔型三种类型。通过了解它们的CT特征并结合临床特点,能够有助于早期诊断和治疗。
Objective To analyze the relationship between chest CT features and IgG4-related disease(IgG4-RD).Methods A retrospective analysis was performed on the clinical data and chest CT scans of 77 patients with confirmed IgG4-RD.The analysis encompassed parenchymal lung lesions,interstitial lung lesions,enlarged chest lymph nodes,pleural cavity lesions,and rare esophageal and thoracic vertebral lesions.Results A total of 40 cases were dominated by parenchymal lung lesions,including 14 cases of solid large nodules/masses and 26 cases of multiple small nodules.Additionally,31 cases were primarily interstitial lesions,comprising 18 cases of axial interstitial type and 13 cases of peripheral interstitial type.Six cases belonged to mediastinal lesions,including one case of posterior mediastinal fibrosis,one case of thoracic vertebral involvement,and one case of esophageal involvement,while the other three cases fell into other categories.Moreover,48 patients exhibited enlarged chest lymph nodes,10 patients had pleural effusion,and 17 patients showed pleural thickening.Most patients(65/77)were treated with glucocorticoids alone or in combination with immunosuppressants.Among the 38 patients who underwent CT examination after treatment,24 showed lesion absorption and a decrease in lesion count.Conclusion IgG4-RD manifests as parenchymal,interstitial,and mediastinal types on chest CT.Understanding their CT features combined with clinical characteristics can facilitate early diagnosis and treatment.
作者
刘艳萍
李媛
LIU Yan-ping;LI Yuan(Department of Radiology,The Guangxi Zhuang Autonomous Region Brain Hospital,Liuzhou 545001,Guangxi Zhuang Autonomous Region,China;West China Hospital of Sichuan University,Chengdu 610000,Sichuan Province,China)
出处
《中国CT和MRI杂志》
2025年第6期67-70,共4页
Chinese Journal of CT and MRI
作者简介
第一作者:刘艳萍,女,副主任医师,主要研究方向:肺部影像诊断。E-mail:280962090@qq.com;通讯作者:李媛,女,副教授,主要研究方向:心胸影像诊断。E-mail:dr.liyuan@163.com。
