根据2022年标准,胸部成像单独足以诊断微观多管炎中的间歇性肺部疾病吗?
Hyunsue Do1, Yong-Beom Park2,3, Ala Woo4
1Division of Rheumatology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
Yonsei medical journal
|November 25, 2025
概括
在微观多管炎 (MPA) 中,胸部成像和肺活检对间歇性肺病 (ILD) 的一致性较低 (40%). 肺活检对于未涉及其他器官的精选骨髓氧化酶阳性患者至关重要.
科学领域:
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
- 病理学 病理学 病理学
背景情况:
- 微观多炎 (MPA) 是一种全身性血管炎,通常与间歇性肺病 (ILD) 相关.
- 在MPA中准确诊断ILD对于适当的管理和分类至关重要.
研究的目的:
- 为了确定MPA患者ILD诊断胸部成像和肺活检之间的一致性.
- 为了比较MPA分类的成像与活检的临床实用性.
主要方法:
- 追溯分析24名MPA患者的胸部成像和肺活检结果.
- 一致性定义为同时通过两种方式确认ILD.
- 对对活检确认的成像发现的预测值的评估.
主要成果:
- 当ILD在胸部成像中存在时,只观察到40%的一致性.
- 在胸部成像中缺少ILD时,发现了高达92.9%的一致率.
- 所有患者都呈现了髓氧化酶-抗核细胞质抗体阳性.
结论:
- 仅靠胸部成像就在MPA中诊断ILD的准确性有限.
- 建议在没有其他器官参与的情况下对选定的MPO阳性MPA患者进行肺活检.
- 多学科团队讨论对于决定是否需要进行肺活检至关重要.
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