肺血管瘤的影像学征象及诊断  

Imaging features and diagnosis of pulmonary angioma

作　　者：周兴惠 戴书华[2] 文利[2] 

机构地区：[1]璧山县人民医院放射科,重庆402760 [2]第三军医大学新桥医院放射科,重庆400037

出　　处：《中华肺部疾病杂志（电子版）》2013年第6期46-48,共3页Chinese Journal of Lung Diseases(Electronic Edition)

摘　　要：目的探讨肺血管瘤的影像学特征及其诊断。方法回顾性分析经X线检查、普通CT及CT血管造影(CTA)检查的21例肺血管瘤患者(其中12例手术证实)的影像资料,采取比较影像学的方法对血管瘤的诊断方法进行综合分析和比对。结果发现带有长条索的分叶状包块,其条索与肺门血管相连为其重要的共有征象。在各种影像检查手段中,CT检查可清晰显示分叶状包块有较粗的条索状结构与肺门血管相连,增强扫描其密度变化与肺血管相似,CTA可显示病灶呈囊状充盈,并直接显示引入与导出的血管影,如病变区听诊有血管性杂音则更具诊断特征。但肿块无引流血管或较小的结节伴有钙化就易误诊为其它良性肿瘤或结核球。结论可根据影像检查的特征性征象对肺血管瘤做出较准确诊断。如果平片或普通CT扫描发现双肺肿块有索条状影与肺门相连,应进行无创的CTA进行检查,以利尽早明确诊断。Objective To investigate the imaging features and diagnosis of lung hemangioma. Methods Images including plain X-ray films, plain CT scan and CT angiography （CTA）for 21 cases of lung hemangioma（ 12 cases were proved by surgery）were analyzed retrospectively, and each method was analyzed and compared comprehensively using the ways in comparative imageology. Results Lobular mass with long strips connecting to the lung hilum was the important common sign of lung hemangioma. All the imaging modafities, CT scan can display the mass and its strip-like structures connecting to the hilar blood vessels with its density changed the same as that of pulmonary vessels on contrast enhanced CT scan ; CTA showed the lesion was filled like a cyst, and showed directly the leading-in as well as the leading-out vessels. If combined with vascular murmur in the auscultatory area of the disease there should be more special features for the diagnosis of lung hemangioma. But the tumor without leading-in vessels or small nodular with calcification are likely to be misdiagnosed as other benign tumors or tubereuloma. Conclusions Lung hemangioma can be diagnosed rather accurately according to the imaging features. If lung mass showed strip-like structures leading to lung hilum on plain film or plain CT scan, noninvasive CTA examination should be done as early as possible to make accurate diagnosis.

关 键 词：肺血管瘤 放射摄影术 CT血管成像 

分 类 号：R734.2[医药卫生—肿瘤]