原发性肺动脉肉瘤的影像表现与误诊分析  

Clinical imaging features and misdiagnosis analysis of primary pulmonary artery sarcoma

作　　者：黄文鹏 侯平[1] 李莉明[1] 刘剑利[1] 许歌[1] 高剑波[1] HUANG Wenpeng;HOU Ping;LI Liming;LIU Jianli;XU Ge;GAO Jianbo(Department of Radiology of the First Affiliated Hospital of Zhengzhou University,Henan Key Laboratory of Image Diagnosis and Treatment for Digestive System Tumor,Zhengzhou 450052,China.)

机构地区：[1]郑州大学第一附属医院放射科/河南省消化肿瘤影像重点实验室,河南郑州450052

出　　处：《中国中西医结合影像学杂志》2021年第5期425-428,469,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金项目(81971615)。

摘　　要：目的:探讨原发性肺动脉肉瘤(PAS)的影像表现及临床特点,提高临床诊断准确率。方法:回顾性分析7例经病理确诊的PAS患者的临床及影像资料,评估病灶的部位、形态、最大短径、边缘、密度、强化方式及强化程度。结果:7例中,肿瘤位于主肺动脉向左右肺动脉干延伸者3例,右肺动脉干3例,左肺动脉干1例;累及段肺动脉2例,累及纵隔1例;病灶最大短径2.63~5.14 cm,平均(3.64±0.98)cm。CT平扫表现为肺动脉及其分支内不均匀低密度;增强扫描1例无强化、2例轻度强化、4例明显强化;4例呈持续性强化、2例渐近性强化、2例边缘显著强化。4例出现蚀壁征,1例病灶内见钙化,1例病灶周围见紊乱侧支血管。5例沿血管侵犯,其中1例侵犯至右肺门及纵隔,2例合并纵隔及肺门淋巴结增大,2例伴肺内转移。结论:PAS临床罕见,症状不典型,CT可清晰显示其病变范围和程度,以及与周围组织的关系,为临床治疗提供帮助。Objective:To explore the imaging manifestations and clinical features of primary pulmonary artery sarcoma(PAS)in order to improve the accuracy of clinical diagnosis.Methods:The clinical and imaging data of 7 patients with PAS diagnosed by pathology were collected retrospectively.The location,shape,maximum short diameter,edge,density,the mode and degree of enhancement of the lesions were analyzed.Results:In the 7 cases,3 lesions located in the main pulmonary artery extending to the left and right pulmonary trunk,3 lesions in the right pulmonary trunk,1 lesion in left pulmonary trunk.2 lesions involved into segmental pulmonary artery,and 1 lesion involved into mediastinum.The maximum short diameter of lesions were 2.63~5.14 cm,(3.64±0.98)cm on average.CT plain scan showed inhomogeneous low density in the pulmonary artery and its branches.After enhancement,there was no enhancement in 1 case,mild enhancement in 2 cases,and obvious enhancement in 4 cases.There were 4 cases showed continuous enhancement,with 2 cases showed asymptotic enhancement and 2 cases showed obvious peripheral enhancement.Wall-erosion sign was found in 4 cases,calcification in 1 case and disordered collateral vessels around 1 case.5 cases showed vascular invasion,among them,right hilar and mediastinum was invaded in 1 case,mediastinal and hilar lymph node enlargement in 2 cases,and pulmonary metastasis in 2 cases.Conclusions:PAS is rare,and its symptoms are not typical.CT can clearly show the extent and degree of PAS,as well as the relationship with surrounding tissues,which can provide information for clinical treatment.

关 键 词：肺肿瘤 血管肉瘤 体层摄影术 X线计算机 诊断 

分 类 号：R734.2[医药卫生—肿瘤]