Abstract:
Pulmonary vasculitis identifies a heterogeneous group of diseases characterized by inflammation, damage and necrosis of the wall of pulmonary vessels. The most common approach to classify vasculitis is according to etiology, therefore dividing them into primary and secondary, with a further sub-classification of primary vasculitis based on the size of the affected vessels (large, medium, and small). Pulmonary involvement is frequently observed in patients with systemic vasculitis and radiological presentation is not pathognomonic, but may vary between diseases. The main findings using high-resolution computed tomography (HRCT) include small vessel wall thickening, nodular lesions, cavitary lesions, reticular opacities, ground-glass opacities (GGO), consolidations, interlobular septal thickening, tracheobronchial stenosis, and aneurysmal dilatation of pulmonary arteries, with or without pleural effusion. Radiological diagnosis alone is difficult since signs and symptoms of lung vessel involvement are often non-specific and might overlap with other conditions such as infections, connective tissue diseases and neoplasms. Therefore, the aim of this review is to describe the most common radiological features of lung involvement in pulmonary vasculitis so that, alongside detailed clinical history and laboratory tests, a prompt diagnosis can be performed.
摘要:
肺血管炎是一组以炎症为特征的异质性疾病,肺血管壁的损伤和坏死。最常见的方法来分类血管炎是根据病因,因此将它们分为主要和次要,根据受影响血管的大小对原发性血管炎进行进一步的分类(大,中等,和小)。在系统性血管炎患者中经常观察到肺部受累,放射学表现不是病理性的,但可能因疾病而异。使用高分辨率计算机断层扫描(HRCT)的主要发现包括小血管壁增厚,结节性病变,空洞性病变,网状混浊,毛玻璃不透明度(GGO),合并,小叶间隔增厚,气管支气管狭窄,肺动脉动脉瘤扩张,有或没有胸腔积液。仅放射学诊断是困难的,因为肺血管受累的体征和症状通常是非特异性的,并且可能与感染等其他疾病重叠。结缔组织疾病和肿瘤。因此,这篇综述的目的是描述肺受累于肺血管炎的最常见的放射学特征,除了详细的临床病史和实验室检查,可以进行及时的诊断。