64排螺旋CT在诊断肺硬化性血管瘤中的价值  

64 Slice CT Diagnosis of Pulmonary Sclerosing Hemangioma

作　　者：亓昌珍[1] 龚建平[1] 蔡武[1] 钱铭辉[1] 庞小娇[1] 周金亮[1] 徐龙江[2] 

机构地区：[1]江苏省苏州市苏州大学附属第二医院影像诊断科,215004 [2]江苏省苏州市苏州大学附属第二医院病理科,215004

出　　处：《临床放射学杂志》2013年第3期433-436,共4页Journal of Clinical Radiology

摘　　要：目的探讨64排螺旋CT在诊断肺硬化性血管瘤(PSH)中的价值方法回顾性分析5例经手术病理证实PSH患者的CT资料。将CT平扫、血管期、肝实质期扫描的0.625 mm层厚图像传至工作站,对各期病灶的最大层面进行重组配准,测量病灶内高强化区和低强化区的CT值,计算强化净值;采用各种图像后处理技术,观察病灶形态学特征及其与周围组织结构的关系。结果 PSH均为单发、境界清楚,呈圆形/椭圆形,3例见支气管血管束挤压征象,2例见空气新月征。4例不均匀强化病灶血管期的高强化区和低强化区的平均强化净值分别为85 HU和28 HU。3例结节型PSH的强化方式为血管期强化净值>肝实质期强化净值,2例肿块型PSH的强化方式为血管期强化净值<肝实质期强化净值。结论 64排螺旋CT不仅能显示PSH形态学表现、支气管血管束挤压征象,而且病灶血管期高强化区的强化净值可以反映PSH特征性血管瘤样区,有利于该病的诊断与鉴别诊断。Objective To assess the diagnostic value of 64 slice CT for pulmonary sclerosing hemangioma （PSH）. Methods 5 cases of PSH proved by operation and pathology were reviewed retrospectvely. All the cases underwent plain CT,vascnlar phase （VP） and hepatic parenchymal phase （HPP） enhanced CT scan. The 0.625 mm images were sent to ADW 4.4 workstation. The largest slice images of PSH on each phase were selected. The high and low enhancement area on VP was found and the same areas on each phase were measured. Net enhancement （NE） on VP and HPP was calculat- ed. The PSH morphology and the relationship with adjacent structures were observed with postprocessing techniques. Re- suits PSH was presented as solitary, well defined boundary, round and oval shaped nodule or mass. The extrusion sign of bronehovascular bundle was seen in 3 eases, and air meniscus sign in 2 cases. In 4 cases with heterogeneous enhancement, the mean NE of high enhancement area and low enhancement area on VP were 85 Hu and 28 Hu. The enhancement pattern in 3 cases of nodular PSH was NEvp 〉 NEHpp, and that in 2 cases of massive PSH was NEvp 〈 NEHpP. Conclusion 64 slice CT not only display morphology and extrusion sign of bronchovascular bundle of PSH, but also reflect net enhancement on VP which indicate distinctive hemangiomatous area of PSH in pathology, which is helpful in diagnosis of PSH.

关 键 词：肺硬化性血管瘤 CT 图像后处理技术 CTPA技术 

分 类 号：R734.2[医药卫生—肿瘤]