淋巴管肌瘤病乳糜胸与肺内囊性病变HRCT表现的相关性分析
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摘要
目的:探讨淋巴管肌瘤病(LAM)乳糜胸的量与肺内囊性病变HRCT表现的相关性。材料和方法:回顾性分析36例临床和/或病理证实为LAM乳糜胸患者的临床和影像学资料。所有患者均行胸部高分辨率CT(HRCT)扫描。由两名影像科医生对以下征象进行分析:(1)乳糜胸量的分级:Ⅰ少量,Ⅱ中量,Ⅲ大量。(2)肺内囊性病变的HRCT表现:囊性病变的大小、累及范围、HRCT的严重度分级。应用χ~2检验,分析LAM乳糜胸的量与肺内囊性病变的大小、累及范围、HRCT的严重度分级的相关性。结果:LAM乳糜胸的量与肺内囊性病变的大小、累及范围及HRCT的严重度分级均没有相关性。结论:LAM乳糜胸的量由多因素决定,与其发病机制有关。LAM乳糜胸的量不能作为评价肺内囊性病变严重度的参考标准。
Objective: The study aims to explore the correlation between the amount of chylothorax and HRCT appearance of lung cyst lesions for LAM. Materials and Methods: 36 LAM with chylothorax patients proved by pathology or clinical results were included in the investigating group. HRCT were performed for all the patients. The imaging manifestations were analyzed by 2 doctors, including(1) grades for the amount of chylothorax: grade Ⅰ, small size; grade Ⅱ, middle size; grade Ⅲ, large size.(2) cyst size, cyst involvement area, HRCT severity grades of pulmonary cyst lesions. Analysis of variance was used in the statistical analysis. Results: There is no relationship between the amount of chylothorax and cyst size, and cyst involvement area, and HRCT severity grades of pulmonary cyst lesions. Conclusions: The amount of chylothorax is decided by many factors, and which is related to the etiology of chylothorax of LAM. The amount of chylothorax cannot be used to evaluate the severity of pulmonary cystic lesion involvement for LAM.
Objective: The study aims to explore the correlation between the amount of chylothorax and HRCT appearance of lung cyst lesions for LAM. Materials and Methods: 36 LAM with chylothorax patients proved by pathology or clinical results were included in the investigating group. HRCT were performed for all the patients. The imaging manifestations were analyzed by 2 doctors, including(1) grades for the amount of chylothorax: grade Ⅰ, small size; grade Ⅱ, middle size; grade Ⅲ, large size.(2) cyst size, cyst involvement area, HRCT severity grades of pulmonary cyst lesions. Analysis of variance was used in the statistical analysis. Results: There is no relationship between the amount of chylothorax and cyst size, and cyst involvement area, and HRCT severity grades of pulmonary cyst lesions. Conclusions: The amount of chylothorax is decided by many factors, and which is related to the etiology of chylothorax of LAM. The amount of chylothorax cannot be used to evaluate the severity of pulmonary cystic lesion involvement for LAM.
引文
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[2]Alessandra B,Maurizio R,Vincenzo C.Lymphangioleiomyomatosis:A case report and review of the literature[J].Tumori Journal,2004,90(5):528-531.
[3]Johnson SR,Cordier JF,Lazor R,et al.European Respiratory Society Guidelines for the diagnosis and management of lymphangioleiomyomatosis[J].European Respiratory Journal,2010,35(1):14-26.
[4]Matsui K,Beasley MB,Nelson WK,et al.Prognostic significance of pulmonary lymphangioleiomyomatosis histologic score[J].American Journal of Surgical Pathology,2001,25(4):479-484.
[5]胡晓文,朱建荣,徐凯峰.1981年至2009年中国淋巴管肌瘤病文献资料汇总分析[J].中国呼吸与危重监护杂志,2010,9(5):508-511.Hu XW,Zhu JR,Xu KF.Lymphangioleiomyomatosis:An Analysis of Cases Reported In Chinese Literature from 1981 to 2009[J].Chinese Journal of Respiratory and Critical Care Medicine,2010,9(5):508-511.(in Chinese).
[6]Chan AL,Kwack S,Jones KD,et al.Lymphangioleiomyomatosis and SZ alpha-1-antitrypsin deficiency:A unique combination[J].Chest,2003,124(2):763-765.
[7]张奇瑾,张春燕,陈孝柏,等.CT淋巴管造影对淋巴管肌瘤病淋巴回流障碍的诊断价值[J].中华放射学杂志,2013,47(9):801-804.Zhang QJ,Zhang CY,Chen XB,et al.Diagnostic value of CT lymphangiography about lymphatic flow disorder of lymphangioleiomyomatosis[J].Chinese Journal of Radiology,2013,47(9):801-804.(in Chinese).
[8]Muller NL,Chiles C,Kullnig P.Pulmonary lymphangiomyomatosis:Correlation of CT with radiographic and functionalstudies[J].Radiology,1990,175(2):335-339.
[9]Theilig D,Doellinger F,MKuhnigk J,et al.Pulmonary lymphangioleiomyomatosis:Analysis of disease manifestation by region-based quantification of lung parenchyma[J].European Journal of Radiology,2015,84(4):732-737.
[10]Abbott GF,Rosado-de-Christenson ML,Frazier AA.From the archives of the AFIP lymphangioleiomyomatosis:Radiologic-pathologic correlation[J].Radiographics,2005,25(25):803-828.
[11]Avila NA,Chen CC,Chu SC,et al.Pulmonary lymphangioleiomyomatosis:Correlation of ventilation-perfusion scintigraphy,chest radiography,and CT with pulmonary function tests[J].Radiology,2000,214(2):441-446.
[12]Avila NA,Kelly JA,Dwyer AJ,et al.Lymphangioleiomyomatosis:Correlation of qualitative and quantitative thin-section CT with pulmonary function tests and assessment of dependence on pleurodesis[J].Radiology,2002,223(1):189-197.
[13]Guermazi A,Brice P,Hennequin C,et al.Lymphography:An old technique retains its usefulness[J].Radiographics,2003,23(6):1541-1560.
[14]Tutor JD.Chylothorax in infants and children[J].Pediatrics,2014,133(4):722-733.
[15]Ryu JH,Doerr CH,Fisher SD,et al.Chylothorax in lymphangioleiomyomatosis[J].Chest,2003,123(2):623-627.
[16]张涤生.实用淋巴医学[M].北京:人民军医出版社,2007.