rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2014-0-1-10-18rentrad-125Research ArticleСтатьиВОЗМОЖНОСТИ КОМПЬЮТЕРНОЙ ТОМОГРАФИИ В ДИАГНОСТИКЕ ПЕРВИЧНЫХ ЛЕГОЧНЫХ ВАСКУЛИТОВPOSSIBILITIES OF COMPUTED TOMOGRAPHY IN THE DIAGNOSIS OF PRIMARY PULMONARY VASCULITISСоколинаИ. А.SokolinaI. A.

к. м. н., доцент кафедры лучевой диагностики и терапии

MD, PhD, Associate Professor of the Department of Radiodiagnostics and Radiotherapy

КоролеваИ. М.KorolevaI. M.

д. м. н., профессор кафедры лучевой диагностики и терапии

MD, PhD, DSc, Professor of the Department of Radiodiagnostics and Radiotherapy

ГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Министерства здравоохранения РФ, ул. Трубецкая, 8, стр. 2, Москва, 119048, Российская ФедерацияРоссияI.M. Sechenov First Moscow State Medical University, Ministry of Health of the RF, ul. Trubetskaya, 8, stroenie 2, Moscow, 119048, Russian FederationRussian Federation201420062016011018Copyright © Соколина И.А., Королева И.М., 20162016Соколина И.А., Королева И.М.Sokolina I.A., Koroleva I.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/125

Цель исследования – изучить основные компьютерно-томографические (КТ) признаки первичных легочных васкулитов на разных этапах развития заболеваний. Материал и методы. Обследованы 89 пациентов, из них с гранулематозом Вегенера (ГВ) – 60, синдромом Черджа–Стросса (СЧС) – 24, микроскопическим полиангиитом (МПА) – 5. Диагноз васкулита установлен на основании комплексного клинико-рентгеноморфологического обследования. КТ-исследование в динамике провели 40 (85,1%) пациентам. Объем лучевого обследования включал: рентгенографию и компьютерную томографию органов грудной полости. Результаты. КТ-признаки ГВ: паренхиматозные инфильтраты – у 41 (68,3%), обширные зоны матового стекла и консолидации – у 16 (21,6%), утолщение стенок бронхов – у 27 (46,7%) пациентов. В 63,4% (n=26) случаев в инфильтратах определялись асептические полости распада. При СЧС КТ-изменения включали: симптом матового стекла (100%), симптом консолидации (54,2%), утолщение стенок бронхов в сочетании с дилатацией их просвета (87,5%), расширение калибра периферических легочных сосудов (45,8%). Для СЧС характерным был мигрирующий характер инфильтратов. Легочные проявления при МПА характеризовались зонами альвеолярной инфильтрации различной интенсивности и протяженности. Заключение. Применение КТ при легочных васкулитах позволяет надежно выявлять и дифференцировать патологические изменения в легких, оценивать их распространенность и контролировать эффективность лечения.

Objective

Objective: to study the main computed tomography (CT) signs of primary pulmonary vasculitis at different stages of disease development. Material and methods. Eighty-nine patients, including those with Wegener’s granulomatosis (WG) (n = 60), Churg–Strauss syndrome (CSS) (n = 24), or microscopic polyangiitis (MPA) (n = 5), were examined. Vasculitis was diagnosed on the basis of comprehensive clinical, X-ray, and morphological examination. CT study was performed in 40 (85.1%) patients over time. Radiography encompassed chest X-ray and computed tomography. Results. The CT signs of WG were as follows: parenchymal infiltrates in 41 (68.3%) patients, vast zones of ground glass and consolidation in 16 (21.6%), and bronchial wall thickening in 27 (46.7%). The infiltrates showed aseptic decay cavities in 26 (63.4%) cases. In CSS, the CT changes included ground glass symptom (100%), consolidation symptom (54.2%), bronchial wall thickening concurrent with bronchial dilatation (87.5%), and increased peripheral pulmonary vessel diameter (45.8%). CSS was typified by migratory infiltrates. The pulmonary manifestations of MPA were characterized by the regions of alveolar infiltration of varying intensity and extent. Conclusion. The use of CT in pulmonary vasculitis makes it possible to reliably detect and differentiate pathological changes in the lung, to estimate their extent and monitor the efficiency of treatment.

 

 

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The authors declare that there are no conflicts of interest present.