肺硬化性血管瘤的CT表现及其相关病理研究  

CT FINDINGS OF PULMONARY SCLEROSING HEMANGIOMA AND THEIR CORRELATED PATHOLOGY

作　　者：王军伟[1] 林吉征[1] 张传玉[1] 蒋钢[1] 刘士锋[1] 

机构地区：[1]青岛大学医学院附属医院放射科,山东青岛266003

出　　处：《青岛大学医学院学报》2012年第6期479-481,484,共4页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的探讨肺硬化性血管瘤(PSH)的影像特点及其相关病理,提高PSH术前诊断的准确性。方法收集24例经手术病理证实的PSH病人的临床资料,将其CT表现与手术病理结果进行回顾性对照分析。结果CT平扫23例PSH表现为圆形、卵圆形孤立性软组织结节或包块,1例为磨玻璃样结节;4例见浅分叶;22例呈均匀等密度,2例密度不均匀,见高、等、低密度区,分别对应于病理上的血管瘤样区、乳头区及实性硬化区。CT增强扫描17例均匀强化,7例不均匀强化,强化程度略高于或明显高于肌肉密度。强化程度明显高于肌肉密度的16例,含有较多的血管瘤成分;强化程度略高于肌肉密度的8例,含有乳头成分较多。3例见粗斑点状钙化。3例瘤周见磨玻璃影,其中1例见空气滞留征及瘤周肺气肿。结论 PSH无特征性的CT表现,但是中年女性病人有以下CT表现,应考虑到PSH诊断:CT平扫呈圆形或卵圆形结节,密度均匀,边界清楚,可见粗点状钙化;CT增强呈中度至明显均匀强化,部分病灶早期强化不均匀,延迟后强化较均匀;瘤周磨玻璃影、空气滞留征及肺气肿。Objective To investigate the CT features of pulmonary sclerosing hemangioma（PSH） and their correlated pathology so as to improve the accuracy of preoperative diagnosis of this condition.Methods Twenty-four pathologically confirmed PSH were collected in this retrospective study.The CT findings and pathologic reports were compared and analyzed.Results On plain CT scan,23 cases presented as a solitary,round or oval soft tissue nodule or mass with well-defined margin,and one case appeared as a ground-glass-like nodule;slight lobulation could be seen in four cases;22 showed even isodensity,two with uneven density,which was corresponding to angiomatous,mamillary,and solid as well as sclerosis regions pathologically.On enhanced CT scan,17 showed an even and seven un-even enrichments,the extent of enrichment was a little bit higher or obviously higher than that of muscular density.Of the 16 cases with the enrichment obviously higher than that of muscle,more component of angioma could be seen;for those the enrichment was a little bit higher than the density of muscle,more component of nipple was noted.Coarsely stippled calcification was found in three cases.Ground-glass-like shadow around the angioma was found in three cases,in which,air trapping and emphysema cold be found around the tumor.Conclusion There are no specific CT features of PSH.But,for middle-aged women with the following CT findings,PSH should be considered： plain CT scan shows a round or an oval-shape nodule,with even density and clear margin and calcified spots;after CT reinforcement,moderate to remarkable enhancement can be seen,and some of the foci manifest uneven enhancement in the early phase,and it is to be comparatively even after delayed reinforcement;ground-glass shadow around the tumor and the signs of air trapping as well as emphysema of lung.

关 键 词：肺硬化性血管瘤 体层摄影术 X线计算机 病理学 

分 类 号：R734.2[医药卫生—肿瘤]