目的探讨肺硬化性血管瘤 (pulmonary sclerosing hemangioma, PSH)的MSCT表现，并对误诊病例进行分 析，提高对本病的诊断水平。方法 回顾 性分析本院2010-2014年经手术或活检病 理证实的PSH患者11例，男性2例，女性9 例；7例行CT增强扫描，4例仅行平扫， 其中5例病灶行多平面重建技术(multiplanar reconstruction，MPR)。结果 11例PSH均为单发，其中10例表现为圆形 或椭圆形，1例形态不规则。5例密度均 匀，6例密度不均，其中3例合并囊变， 2例可见斑点状钙化。4例可见浅分叶， 余病灶边界较光滑。增强扫描病灶实性 部分均呈较明显强化，并持续强化,其中 2例病灶延迟强化。1例病灶表现为磨玻 璃密度结节，5例显示“贴边血管征”， 2例显示“尾征”。术前共误诊6例，其 中2例误诊为周围型肺癌；1例误诊为细 支气管肺泡癌；1例误诊为错构瘤；1例 误诊为转移瘤；1例误诊为结核球。结论 PSH多见于中老年女性，常表现为肺内孤 立性结节或肿块，MSCT表现有一定的特 点，明显强化、“血管贴边征”、“尾 征”等影像特点有助于其诊断，从而减 少术前误诊；MPR技术能帮助病灶空间 定位，更好地显示病灶与邻近组织的关 系。

Objective To investigate the MSCT features of pulmonary sclerosing hemangioma (PSH) and analyzed the misdiagnosed cases,in order to improve the diagnostic accuracy. Methods MSCT features of 11 patient(9 females and 2 males)with PSH which confirmed by pathology from 2010 to 2014 were analyzed retrospectively,among which 7 cases underwent plain and enhanced CT scan,4 cases underwent plain CT scan only,and 5 cases had multiple planar reconstruction. Results A total of 11 cases were solitary,10 were round or oval in shape,and 1 case was irregular nodules.Five cases showed homogeneous density and the other 6 cases showed inhomogeneous,in which,3 cases with cystic degeneration,2 cases showed spotty calcification.All cases had smooth edge except 4 cases with light lobulated edge.All the cases had obvious enhancement,and 2 cases had delayed enhancement.One case showed ground glass density,"welt vessel signs" in 5 cases and "tail signs" in 2 cases.Six cases were preoperative misdiagnosed.Two of them were misdiagnosed as peripheral lung cancer,one was diagnosed as bronchioalveolar carcinoma, one hamartoma,one metastasis and one tuberculoma. Conclusions The PSH is common in middle-aged and senior women and had some special MSCT features.Obvious enhancement,"welt vessel signs" and "tail signs" were very helpful for the diagnoses. The MPR can help the spatial orientation and display the relationship between the lesions and adjacent tissues.