【摘要】 目的 分析肺泡蛋白沉积症(pulmonary alveolar proteinosis，PAP)的多层CT表现特征。方法 回顾性研究我院2000年1月～2005年6月经病理学证实的6例PAP的多层CT表现，并与病理学改变相对照，探讨PAP的影像病理学联系及多层CT表现特征。结果 6例(100%)患者多层CT表现为双肺散在分布毛玻璃样高密度影，与周围组织分界清楚，呈地图样表现，病理学活检见肺泡腔内蛋白质样物质沉积，其中4例(66%)小叶间隔增厚，可见间隔水肿及淋巴细胞浸润，HRCT呈铺路石样表现。所有病例未见纵隔、肺门淋巴结肿大。结论 PAP的多层CT表现能够反映其病理学特征，边界清楚的毛玻璃样高密度影，呈地图样及铺路石样表现能高度提示PAP诊断。

     【关键词】 肺泡蛋白沉积症；体层摄影术，X线计算机；病理学

    Comparative study of multislice spiral CT findings and pathological results in patients with pulmonary alveolar proteinosis

    QIN Jie，MENG Xiao-chun，SHAN Hong，et al.Department of Radiology,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China

    【Abstract】 Objective To analyze the features of pulmonary alveolar proteinosis(PAP) in multislice spiral CT(MSCT) examinations.Methods The MSCT appearances of PAP in 6 patients proved by pathology were evaluated and compared with their pathological results.Results All the 6 patients with PAP presented ground-glass opacities with well-defined margins on MSCT,creating “geographic” pattern,reflected the effusion of proteinaceous material within the alveoli in PAP.Thickened interlobular septa,looking as the “crazy-paving”,was found in 4 cases in high-resolution CT(HRCT),correspondence with edema and lymphocyte exudation in interlobular septa in pathological findings.No mediastinal and hilar adenopathy was found.Conclusion The characteristic appearances of PAP on MSCT correspond to its pathological features.The “crazy paving” sign in geographical areas of pulmonary opacification greatly suggests PAP diagnosis. ......