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首页> 外文期刊>Seminars in Ultrasound, CT, and MRI >Chronic hypersensitivity pneumonitis and pulmonary sarcoidosis: Differentiation from usual interstitial pneumonia using high-resolution computed tomography
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Chronic hypersensitivity pneumonitis and pulmonary sarcoidosis: Differentiation from usual interstitial pneumonia using high-resolution computed tomography

机译：慢性超敏性肺炎和肺结节病：使用高分辨率计算机断层摄影术与通常的间质性肺炎相鉴别

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摘要

The distinction of chronic hypersensitivity pneumonitis (HP) or advanced-stage sarcoidosis from idiopathic pulmonary fibrosis or usual interstitial pneumonia is important because each disease is managed differently and may have a different prognosis. The analyses of pattern and distribution of lung parenchymal abnormalities on high-resolution computed tomography scans help differentiate among the 3 diseases. In chronic HP, the presence of lobular areas of decreased attenuation and centrilobular small nodules and the absence of lower lung zone predominance are characteristically observed. In advanced-stage sarcoidosis, patchy areas of reticulation, traction bronchiectasis, architectural distortion, honeycomblike cysts, bullae, and paracicatricial emphysema are observed in the upper and middle lung zones. Lung bases are usually spared. In idiopathic pulmonary fibrosis or usual interstitial pneumonia, however, the presence of honeycombing with lower lung zone predominance and the absence of centrilobular small nodules are important findings that allow us to differentiate the disease from chronic HP or advanced-stage sarcoidosis. In the 3 diseases, most important prognosis-predicting factor is the extent of fibrotic score (the extent of honeycombing and reticulation) calculated on high-resolution computed tomography scans or fibrosis estimated on chest radiographs.
机译：慢性超敏性肺炎（HP）或晚期结节病与特发性肺纤维化或通常的间质性肺炎的区别很重要，因为每种疾病的治疗方法不同且预后可能不同。在高分辨率计算机断层扫描上分析肺实质异常的模式和分布有助于区分这三种疾病。在慢性HP中，特征性地观察到存在衰减减弱的小叶区域和小叶小结节，并且不存在下肺区优势。在晚期结节病中，在肺的上部和中部区域观察到斑状区域的网状结构，牵引性支气管扩张，建筑变形，蜂窝状囊肿，大疱和附属肺气肿。肺部基地通常是幸免的。然而，在特发性肺纤维化或通常的间质性肺炎中，存在具有较低肺区优势的蜂窝状结构和不存在小叶小结节是重要的发现，使我们能够将疾病与慢性HP或晚期结节病区分开。在这3种疾病中，最重要的预后预测因素是通过高分辨率计算机断层扫描计算得出的纤维化评分（蜂窝状和网状分布的程度）或在胸部X光片上估计的纤维化程度。

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