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目的探讨全数字化(DR)胸片表现为多发粟粒样病变不同疾病的影像特征及其病理机制。方法回顾性分析37例诊断明确、临床及影像资料齐全而肺内均可见多发粟粒样病变的病例。结果37例中:肺结核8例、弥漫肺转移瘤6例、结缔组织病5例、肺感染4例、白血病肺浸润3例、尘肺3例、吸入性肺炎2例、肺小动脉壁钙化2例、肺水肿2例、特发性肺间质纤维化1例、恙虫病肺间质炎1例,大部分病变的形态、分布、演变过程及伴随征象有一定的特征性。结论肺部出现粟粒样改变的病种繁多,掌握其各自的影像特点及病理机制对正确诊断非常重要。DR胸片及高分辨CT结合临床常可作出正确的诊断或缩小诊断范围。
Objective To investigate the imaging features and pathological mechanism of all digital (DR) chest radiographs for different diseases with multiple miliary lesions. Methods Retrospective analysis of 37 cases of clear diagnosis, clinical and imaging data are complete and multiple cases of miliary lesions can be seen in the lungs. Results In 37 cases, there were 8 cases of pulmonary tuberculosis, 6 cases of diffuse lung metastasis, 5 cases of connective tissue disease, 4 cases of pulmonary infection, 3 cases of lung infiltration of leukemia, 3 cases of pneumoconiosis, 2 cases of aspiration pneumonia, 2 cases of pulmonary arterial wall calcification , Pulmonary edema in 2 cases, idiopathic pulmonary fibrosis in 1 case and tsutsugamushi disease in 1 case. The morphology, distribution, evolution and concomitant signs of most of the lesions have certain characteristics. Conclusion There are many kinds of miliary diseases in the lungs. It is very important to understand the characteristics of their respective images and the pathological mechanism for correct diagnosis. DR chest radiography and high-resolution CT can often make the correct diagnosis or narrow the scope of diagnosis.