In ten patients with idiopathic adult respiratory distress syndrome (ARDS) who had histopathologically diffuse alveolar damage (DAD), and who did not have specific underlying diseases, we compared the histopathological findings with their radiographic images in order to study the detail analysis of radiographic images and the clinical courses. These patients were roughly classified as having the interstitial pneumonia dominant type (type IP) of idiopathic ARDS, in which alveolar septal thickening, alveolitis, or both were the predominant histological findings and images showed increasing attenuation of lung fields with small honeycomb lung, or the organizing pneumonia dominant type (type OP), in which organizing exudate predominantly filled the alveoli histologically and images showed consolidation shadows with some air. Hyaline membrane was seen very frequently in patients with a short clinical course, and in accordance with a longer clinical course, widespread fibrosis and honeycomb lung covered by organizing hyaline membrane was seen with both types. Patients with type OP in whom collapse of the normal pulmonary structure was less and for whom changes on radiographic images were larger seemed to respond relatively favorably to steroid treatment, as judged from pulmonary function and radiographic images.

译文

在十名患有组织病理学弥漫性肺泡损伤 (DAD) 且没有特定基础疾病的特发性成人呼吸窘迫综合征 (ARDS) 患者中,我们将组织病理学发现与他们的影像学图像进行了比较,以研究影像学图像的详细分析和临床过程。这些患者被大致归类为特发性ARDS的间质性肺炎显性类型 (IP型),其中肺泡间隔增厚,肺泡炎或两者都是主要的组织学发现,并且图像显示小蜂窝肺的肺视野衰减增加,或组织肺炎显性类型 (OP型),其中组织渗出液在组织学上主要填充肺泡,图像显示有一些空气的巩固阴影。在临床病程较短的患者中,透明膜非常常见,并且根据较长的临床病程,两种类型的透明膜均被组织透明膜覆盖,广泛的纤维化和蜂窝状肺。根据肺功能和影像学图像判断,正常肺部结构塌陷较少且影像学变化较大的OP型患者似乎对类固醇治疗反应相对有利。

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