肺硬化性血管瘤多排螺旋CT表现及误诊分析  

Multi-slice features and misdiagnosis of pulmonary sclerosing hemangioma

作　　者：郭兴 韦建林 崔惠勤 

机构地区：[1]柳州市工人医院放射科,广西柳州545005

出　　处：《中华实用诊断与治疗杂志》2015年第8期822-824,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的探讨肺硬化性血管瘤的多排螺旋CT(multi-slice CT,MSCT)表现,分析误诊原因。方法回顾性分析18例肺硬化性血管瘤患者的临床及MSCT影像资料。结果 MSCT诊断肺硬化性血管瘤10例,误诊为周围型肺癌3例,炎性假瘤2例,错构瘤1例,巨淋巴结增生1例,肺曲菌球1例;MSCT平扫示病灶呈圆形或类圆形13例,不规则结节状5例;12例病灶边缘光整,5例可见浅分叶,1例边缘不规则并可见胸膜凹陷征;12例病灶密度均匀,4例见点状钙化,2例病灶内见略高密度区;15例行增强扫描者中13例呈均匀强化,2例不均匀强化;18例中3例见空气新月征,3例见贴边血管征,1例见肺动脉主征,2例见周围晕征。结论肺硬化性血管瘤MSCT表现不典型者误诊率较高,确诊需依据手术组织病理检查。Objective To investigate the multi-slice CT （MSCT） features of pulmonary sclerosing hemangioma （PSH） to analyze the reason of misdiagnosis. Methods The clinical and MSCT data of 18 patients with PSH were analyzed retrospectively. Results In 10 patients with MSCT confirmed PSH, 3 were misdiagnosed as peripheral lung cancer, 2 as inflammatory pseudotumor, 1 as hamartoma, 1 as giant lymph node hyperplasia, and 1 as pulmonary aspergilloma. MSCT plain scan showed round or oval lesions in 13 patients, and irregular nodular in 5. The lesion with smooth edge was found in 12 patients, with visible superficial lobulation in 5, and irregular margin and visible pleural indentation in 1. It also showed homogeneous density in 12, calcification in 4, and slightly higher density area in lesion in 2. In 15 patients undergoing enhanced scan, 13 showed uniform strengthening, and inhomogeneous enhancement in 2. Three patients were found air crescent sign, 3 were found welt vascular syndrome, 1 was found pulmonary artery main syndrome, and 2 were found surrounding halo sign. Conclusion The misdiagnosis rate is high in PSH patients with no typical MSCT characteristics. A definite diagnosis needs histopathological result.

关 键 词：肺硬化性血管瘤 X线计算机 体层摄影术 误诊 

分 类 号：R734.2[医药卫生—肿瘤]