医学影像英语每日学丨159.Combined pulmonary fibrosis and emphysema syndrome
每天朗读一段医学影像学英语文章
领读： YWT老师
HISTORY
A 58-year-old man presented with exertional dyspnoea. He was a former smoker (40 packs-years), had no professional exposure, no clinical signs of connective tissue disease and quit smoking 4 years ago. On physical examination he showed diffuse rhonchi, velcro-like crackles on the lung bases, clubber fingers and cyanosis.
IMAGING FINDINGS
Chest X-ray demonstrated lower lobe reticular markings and upper lobe hyperlucency. High Resolution Computed Tomography (HRCT) was performed and showed predominantly upper lobe paraseptal bullae, small areas of low attenuation with ill-defined margins and without visible walls and lower lobe intra- and interlobular septal thickening, ground-glass opacities, traction bronchiectasis, architectural distortion and honeycombing.
DIAGNOSIS
Combined pulmonary fibrosis and emphysema syndrome
DISCUSSION
The consensus definition of CPFE has been challenged; although initially considered to represent an incidental coexistence of two separate entities, CPFE has been recently proposed as a distinct syndrome. Its diagnosis is mainly based on HRCT findings and clinically is characterized by relatively preserved spirometric values and disproportionate impairment of gas exchange.
from: http://www.eurorad.org
(以上主题选自心胸影像病例汇）
Notes:
1. exertional [ɪɡ'zɜ:ʃənəl] adj.劳累性的
2. dyspnoea [dɪsp'ni:ə] n. 呼吸困难
3. rhonchi ['rɑŋkɪ] n. 干啰音
4. velcro-like crackles
A popular term for dry or fine crackles—fancifully likened to the sound of a Velcro closure being opened—which are heard posterolaterally at the lung bases and associated with interstitial lung disease
5. cyanosis [ˌsaɪə'noʊsɪs] n. 发绀
6. reticular [rɪ'tɪkjələ] adj.网状的
7. lucency ['lu:sənsɪ] n. 光亮，透明
8. paraseptal 间隔旁
9. bullae [ˈbʊli] n. 肺大泡
10. bronchiectasis [brɑŋkɪ'ektəsɪs] n. 支气管扩张
11. emphysema [ˌɛmfɪˈsimə, -ˈzi-] n. 肺气肿
12. spirometric [spaɪərɒ'metrɪk] adj. 肺活量测定的
【Combined pulmonary fibrosis and emphysema syndrome 肺纤维化肺气肿综合征】
病史：男，58岁，劳累性呼吸困难。有吸烟史（40包/年），无职业暴露史，无结缔组织病，戒烟4年。体检显示双肺底支气管弥漫性的Velcro啰音，杵状指和紫绀。
影像表现：胸片显示双肺下叶网状影，上叶过度透亮。HRCT可见上叶为主的间隔旁肺大泡，表现为小面积的低密度影，边界不规则，无囊壁。双下叶小叶内、小叶间间隔增厚，磨玻璃影，牵拉性支气管扩张，结构扭曲和蜂窝状改变。
诊断：肺纤维化肺气肿综合征
讨论：CPFE的统一定义还有待商榷，最初认为是同时患有两种疾病，现在又提出是一种独立的综合征。诊断主要依靠HRCT和临床特征性指标（相对剩余肺活量值和气体交换功能不成比例削减）。
来源：每天朗读一段医学影像学英语文章
圈主
深圳市人民医院放射科副主任医师杨敏洁