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·胸部疾病·

肺部硬化性血管瘤的64排螺旋CT特征分析

作者:杨丽萍 季学兵

所属单位:安徽省合肥市安徽省立医院南区影像中心 (安徽 合肥 230031)

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摘要

目的 探究肺部硬化性血管瘤的64排螺旋CT影像特征,以提高临床诊断水平。方法 回顾性分析经手术病理证实的 22例肺硬化性血管瘤患者,分析其64排螺旋CT影像学特征及临床组织病理学表现。结果 22例患者均为女性;年龄 24-59岁,平均42.3±13.2岁。所有患者均为单发病灶,其中右肺上叶5例,右肺中叶3例,右肺下叶6例,左肺上 叶2例,左肺下叶6例。CT征像:所有病例均未见毛刺征;相对特征征像有,空气新月征10例(45.5%),晕征13例 (59.1%),贴边血管征7例(31.2%),其中接近肺门血管者血管贴边征更明显。10例患者伴有点状及斑片状钙化。所 有病例增强后均明显强化,其中7例均匀强化,动脉期CT值增加34±12Hu,延迟期CT值增加62±23Hu;11例不均匀 强化,动脉期CT值增加23±14Hu,延迟期CT值增加54±18Hu;4例为延迟强化。结论 肺部硬化性血管瘤好发于女 性,有多种相对特征性的CT表现,CT对其诊断具有一定的价值。

Objective To explore the features of pulmonary sclerosing hemangioma by 64-row spiral CT, in order to provide evidence for clinical diagnosis. Methods The 64- row spiral CT findings and clinical data of 22 cases of PSH which were histologically confirmed ,were retrospectively analyzed. Results All patients were female,aged 24-59 years old, average age was 42.3±13.2 years old. All cases were signal lesion. Distribution of lesions was as below: 5 cases in the upper lobe of right lung , 3 in the middle lobe of right lung, 6 in the lower lobe of right lung, 2 in the upper lobe of left lung, 6 in the lower lobe of left lung. No spicule sign was found in all cases. Relative characteristic signs were as below: air crescent sign in ten cases(45.5%), halo sign in thirteen cases(59.1%), welt vessel syndrome in seven cases(31.2%), moreover the lesion was closer to the lung hilus, the welt vessel syndrome was more obvious. 10 cases were associated with punctuate or patchy calcification. All cases were enhanced obviously after injection of iodinated contrast agent , among them , homogeneous enhancement was found in 7 cases, which CT value increased 34±12Hu in the arterial phase, 62±23Hu increased in the delayed phase; inhomogeneous enhancement was found in 11 cases, which CT value increased 23±14Hu in the arterial phase, 54±18Hu increased in the delayed phase; delayed enhancement was found in 4 cases. Conclusion Pulmonary sclerosing hemangioma is more common in female, there are several relatively specific CT manifestations, and CT scanning has certain diagnostic value.

【关键词】肺部硬化性血管瘤;64排螺旋CT;组织病理

【中图分类号】R732.2

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2015.06.010

前言

肺部硬化性血管瘤(Pulmonary Sclerosing Hemangioma)是一种临床少见的肺部原发性良性肿 瘤,发生率约占肺部原发肿瘤的11%,来源于II型肺 泡上皮细胞。1956年由Liebow与Hubbell首次报道, 因其结构类似于皮肤硬化性血管瘤而得名[1]。多数患 者的症状与体征不明显或不典型,临床上极易发生误 诊。本文回顾性分析22例经病理证实的PSH,探讨其64排螺旋CT特点,并与组织病理表现进行对比分析, 以提高该病的诊断率。