周围型肺错构瘤多层螺旋CT诊断及鉴别  

Diagnosis and differential diagnosis of peripheral pulmonary hamartoma through multi-slice CT

作　　者：刘建立[1] 

机构地区：[1]山东省菏泽市立医院cT室,274000

出　　处：《中国医师进修杂志》2016年第4期289-292,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨周围型肺错构瘤的多层螺旋cT特点，以提高对本病的诊断符合率。方法回顾性分析16例经手术病理证实的周围型肺错构瘤患者的多层螺旋CT表现。结果多中年发病，年龄22～67岁，平均43．2岁。16例患者均为肺内单发结节，边界清晰。右肺7例，左肺9例。病灶圆形6例；类圆形7例；不规则形3例，其中浅分叶1例，深分叶2例。2例可见胸膜牵线征，1例见血管集束征。病灶直径1．5-5．2cm，平均2．48cm，1例〉5cm。典型爆米花样钙化1例，斑点状钙化2例，环状钙化1例，病灶内只有脂肪密度影3例，既有脂肪密度影又有钙化2例，7例呈均匀软组织密度，既无脂肪密度影也无钙化。增强扫描：5例无异常强化，11例病灶内软组织轻度强化。结论脂肪和钙化是周围型肺错构瘤的典型征象，而边界清晰及增强扫描无强化或轻度强化亦是重要依据，分叶及胸膜牵线征并不能除外肺错构瘤可能。Objective To investigate the characteristics of peripheral pulmonary hamartoma with multi-slice CT, in order to improve the accuracy of diagnosis of the disease. Methods The multi-slice CT manifestations in 16 peripheral pulmonary hamartoma patients who were confirmed by pathology were retrospectively analyzed. Results Most of the patients were in middle age, whose ages were 22 - 67 years old, and the average age was 43.2 years old. All the patients had solitary pulmonary nodules, with clear boundary, with 7 cases in right lung and 9 cases in left lung. Pulmonary nodules were round in 6 cases, similarity round in 7 cases and irregular shape in 3 cases, among which 1 case had shallow lobulation and 2 cases had deep lobulation. Two cases had pleural up syndrome, and 1 case had vascular convergence sign. The diameter of the lesions was 1.5 - 5.2 cm, and the average was 2.48 cm, with 1 case 〉 5 cm. One case showed a typical popcorn calcification. There were stippled calcification in 2 cases and annular calcification in 1 case. Intralesional fat only showed in 3 cases, and both fat and calcification in 2 cases. Seven cases showed homogeneous soft tissue density, neither fat nor calcification. Enhanced scan： 5 cases had no abnormal enhancement, 11 had mild enhancement of soft tissue. Conclusions Fat and calcification are the typical signs of peripheral pulmonary hamartoma. Clear boundary and no enhancement or slight enhancement is also the important diagnostic basis, and lobulation and pleural up syndrome do not exclude the possible pulmonary hamartoma.

关 键 词：肺 错构瘤 体层摄影术 X线计算机 回顾性研究 

分 类 号：R734.2[医药卫生—肿瘤]