びまん性肺胞障害の繊維化過程の解析 : コンピュータ断層像と病理像の相関

概要

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To determine the clinical usefulness of computed tomography (CT) in acute respiratory distress syndrome (ARDS), CT-pathologic correlation was studied using inflated fixed lungs having diffuse alveolar damage (DAD). Twenty five cases of DAD as determined by post-mortem pathologic examinations were investigated. The lungs were inflated and fixed with a fixative including polyethylene glycol 400, 95% ethyl alcohol, 37% formaldehyde and water, then contact radiographs and high-resolution CT (HRCT) images of the specimens were obtained and histologic sections were prepared. Direct one-to-one correlative studies between HRCT images, macroscopic, submacroscopic and histological features prepared from the same slices were carried out. Ground-glass opacity correlated mainly to acute stage of DAD with extant alveoli. Air-space consolidation correlated to a filling process of the distal air-spaces with dense fibrosis or severe exudations. Fibrosis in the area of air-space consolidation was recognized by a distortion in lung architecture, bronchiectasis, and air-bronchiologram as seen on HRCT images. CT may have the potential to characterize pulmonary structural changes such as those seen in the fibrosing process in DAD.
札幌医科大学の論文
1997-10-01