摘要
目的：研究肺部韦格纳肉芽肿（WG）多层螺旋CT（MSCT）形态学特征与患者血清抗中性粒细胞胞浆抗体胞浆型（CANCA）、抗中性粒细胞胞浆抗体核周型（PANCA）、抗蛋白酶3抗体（PR3-ANCA）和抗髓过氧化物酶抗体（MPO-ANCA）的关系及诊断价值。方法：9例经病理证实的肺部WG和对照组9例非WG患者行MSCT扫描和血清自身抗体指标CANCA、PANCA、PR3-ANCA、MPO-ANCA检测，将MSCT特征与血清自身抗体指标进行对照分析。结果：肺WG组CANCA，PR3-ANCA阳性率明显高于对照组（P＜0.05）；血清测定PR3-ANCA诊断WG的敏感性和特异性最高；肺部WG患者血清PR3-ANCA水平在MSCT征象-炎症征象、结节征和空洞征有无情况下有显著差异（P＜0.05）。结论：利用MSCT诊断肺部WG有一定局限性，但是MSCT某些征象与血清PR3-ANCA水平具有较强关联性，能够一定程度上反映肺部WG的病理变化。
Abstract
Objective: To study the MSCT features of pulmonary Wegener’s granulomacytosis(WG) and the correlation with serum anti-neutrophil cytoplasmic antibodies which include the cytoplasm(CANCA), perinuclear type(PANCA), anti-proteinase 3 antibodies(PR3-ANCA) and anti-myeloperoxidase antibody(MPO-ANCA). And to assess the value of both methods in the diagnosis of pulmonary WG. Methods: Nine cases of pathologically confirmed pulmonary WG and 9 cases of non-WG patients received MSCT scanning and serum anti-neutrophil cytoplasmic antibodies CANCA, PANCA, PR3-ANCA, MPO-ANCA detection, MSCT features and serum anti-neutrophil cytoplasmic antibodies of WG and non-WG were compared． Results: The CANCA and PR3-ANCA positive rate of WG was significantly higher than that of the non-WG(P<0.05); The PR3-ANCA have the highest sensitivity and specificity in the diagnosis of WG; the PR3-ANCA levels of WG has a significant difference(P<0.05) in the presence or absence of some signs including inflammation, nodules and cavities. Conclusion: Though in the diagnosis of pulmonary WG with MSCT have a certain limitation, some MSCT features and the PR3-ANCA levels have a strong correlation. It can express the pathological state of development of the lesions to some extent.
关键词
韦格纳肉芽肿病 /
肺疾病 /
抗体 /
抗中性白细胞胞质 /
体层摄影术 /
螺旋计算机
Key words
Wegner’s granulomatosis /
Lung diseases /
Antibodies /
antineutrophil cytoplasmic /
Tomography /
spiral computed
黄 刚;马娅琼.
肺部韦格纳肉芽肿MSCT征象与ANCA的相关性及诊断价值的研究[J]. 中国临床医学影像杂志. 2013, 24(6): 393-396
HUANG Gang;MA Ya-qiong.
The diagnostic value of MSCT features of pulmonary Wegener’s granulomacytosis and its correlation with ANCA[J]. Journal of China Clinic Medical Imaging. 2013, 24(6): 393-396
中图分类号：
Ｒ563
Ｒ593.9
Ｒ814.42
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