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肺CT名詞——蜂窩(honeycombing)

2021-01-04 17:17:42 127

病理學表現:含有無數厚纖維性壁的囊性氣腔并已發生破壞和纖維化的肺組織,是各種肺病的晚期表現,伴腺泡結構的完全喪失。囊腫直徑的大小自幾毫米到幾厘米,壁厚度不等,囊的內襯為化生細支氣管上皮。

X 線胸片和CT 表現: 在X 線胸片上蜂窩的表現非常近似環影,典型的直徑為3~10 mm,壁厚1~3 mm,類似蜂巢,所見提示為終末期肺病。在CT 上表現為成簇的囊狀氣腔,直徑3~10 mm,但偶可達2.5 cm。蜂窩常位于胸膜下,有清楚的壁為其特征,它是一種可確定為肺纖維化的CT 征象。因為常認為蜂窩對診斷肺纖維化有特異性,故其是診斷尋常性間質性肺炎的重要標準,但對該術語的應用要慎重,因為它可能直接影響病人的治療。

Pathology.—Honeycombing represents destroyed and fibrotic lung tissue containing numerous cystic airspaces with thick fibrous walls, representing the late stage of various lung diseases, with complete loss of acinar architecture. The cysts range in size from a few millimeters to several centimeters in diameter, have variable wall thickness, and are lined by metaplastic bronchiolar epithelium. 

Radiographs and CT scans.—On chest radiographs, honeycombing appears as closely approximated ring shadows, typically 3–10 mm in diameter with walls 1–3 mm in thickness, that resemble a honeycomb; the finding implies end-stage lung disease. On CT scans, the appearance is of clustered cystic air spaces, typically of comparable diameters on the order of 3–10 mm but occasionally as large as 2.5 cm (Fig 1). Honeycombing is usually subpleural and is characterized by well-defined walls . It is a CT feature of established pulmonary fibrosis . Because honeycombing is often considered specific for pulmonary fibrosis and is an important criterion in the diagnosis of usual interstitial pneumonia , the term should be used with care, as it may directly impact patient care.  

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Figure 1: Transverse CT scan shows honeycombing.

本文編譯于Fleischner Society: Glossary of Terms for Thoracic Imaging -- Hansell et al. 246 (3): 697 Figure 25 -- Radiology


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