医学百科网 >>所属分类 >> 临床症状    胸部症状   

肺部磨玻璃影(GGO)

标签: 肺部磨玻璃影(GGO)

编辑词条
目录

概述编辑本段回目录

肺部磨玻璃影GGO)是指高分辨率CT图像上表现为密度轻度增加,呈局灶性云雾状密度阴影,但其内的支气管及血管纹理仍可显示。其病理基础对为肿瘤细胞沿肺泡间隔生长。肺泡壁增厚,但肺泡腔未闭塞,其内可有少量黏液或脱落的肿瘤细胞。该征象是一种有特征性而非特异性的影像学表现,可见于各种炎症、水肿、纤维化及肿瘤等病变。此征象常为早期肺部疾患的表现,及时发现并诊断对临床正确处理及预后的判断有重要意义。    医学百科网-MedBaike. com

分类编辑本段回目录

GGO在影像学上按照分布范围分为弥漫性和局限性两大类。弥漫性GGO在高分辨CT表现为肺野内弥漫分布的、边界模糊不清的、淡薄的略高密度影,常见于过敏性肺炎、肺水肿、肺泡蛋白沉积症、皮肌炎、风湿性关节炎及放射性肺炎等疾病的早期阶段,也可见于肺出血和肺炎消散期。而胸外科医师更关心的是肺内局限性GGO,希望从中辨认出早期肺癌,达到早发现、早诊断、早治疗。

医学百科网-MedBaike. com

处理原则编辑本段回目录

美国 NCCN建议发现肺部磨玻璃影(GGO)复查指南: 医学百科网-MedBaike. com

1.<5mm,12个月后复查CT,如稳定,每年低剂量螺旋CT 检查,至少持续2年;

医学百科网-MedBaike. com

2.5~10mm,6个月后复查CT,如稳定,每年低剂量螺旋CT 检查,至少持续2年; 医学百科网-MedBaike. com

3.>10mm,3~6个月后复查低剂量螺旋CT ,如稳定,可以6~12个月后复查低剂量螺旋CT ,或者活检或手术切除。 医学百科网-MedBaike. com

以上动态观察中如果发现结节增大或者实性变,除直径<5mm者可以考虑3~6个月动态复查低剂量螺旋CT 外,其他均应手术切除。

医学百科网-MedBaike. com

在CT随访中如果经抗生素抗炎等各种内科处理后,由GGO实变形成结节称磨玻璃结节。在≤5mm时可以考虑为是不典型腺瘤样增生,在CT上呈典型的局灶性磨玻璃结节表现。它属于癌前病变,但达不到肺原位腺癌的标准。腺瘤样增生可以在长达2~3年的时间内稳定不变,但会逐步发展为原位腺癌,进一步发展为具有侵袭力的肺腺癌。 医学百科网-MedBaike. com

 另附磨玻璃影的和实性结节的CT照片如下:从左到右依次为纯GGO(磨玻璃影)、混合GGO、实性结节影。 医学百科网-MedBaike. com

医学百科网-MedBaike. com

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