肺孤立良性结节的HRCT表现及病理基础研究  

Research of HRCT-Pathologic Correlation in Benign Solitary Pulmonary Nodules

作　　者：伍建林[1] 王圆圆 沈慧聪[1] 王淼淼[1] 王克礼 

机构地区：[1]大连医科大学附属一院放射科,辽宁大连116011

出　　处：《中国医学影像技术》2003年第10期1348-1350,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的　探讨肺良性结节HRCT表现特征及其病理基础以提高诊断正确率。方法　分析 39例经手术病理证实直径≤ 3.0cm肺孤立良性结节HRCT图像边缘和内部表现特征并与病理组织学对照研究 ,其中包括结核球 15例 ,炎性假瘤 10例 ,错构瘤 10例 ,硬化性血管瘤 2例 ,其他 2例。结果　形态呈圆形或类圆形 33例 (85 % ) ,边缘清楚35例 (90 % ) ,病理上多有包膜或周围肺膨胀不全带 ;浅分叶者 2 5例 (6 4 % ) ;粗长毛刺 14例 (36 % ) ,为小叶间隔炎性增厚或被牵拉的小血管 ;血管集束征 13例 (33% ) ,为正常血管伸达病灶边缘或进入病灶 ;胸膜凹陷征 13例 (33% ) ;卫星病灶 13例 (33% ) ,为病灶周围肉芽肿或干酪坏死病灶。内部结构密度均匀者 2 3例 (5 9% ) ;不均匀者 16例 (4 1% ) ,钙化 12例 (30 .7% ) ,空洞 6例 (15 % ) ,多为向心性 ,裂隙样或新月样 ,内壁光滑。结论　HRCT能最大程度反映肺良性结节边缘和内部病理特征 ,在肺孤立性结节的鉴别诊断中发挥主导作用。Objective To study the HRCT features and its pathologic basis of solitary pulmonary benign nodules (SPN) for improving correct diagnosis.Methods Thirty nine cases with benign SPN less than 3cm in diameter proved by pathology were studied with HRCT-pathologic correlation about it's edge and internal characteristics.The benign nodules include 15 tuberculomas,10 inflammatory pseudotumors,10 harmatomas,2 sclerotic hemangioma and 2 other nodules.Results Thirty three cases (85%) shaped round or oval and 35 cases (90%) with well-defined margin were due to capsule or atelectatic zone surrounding the nodules;25(64%) cases with superficial lobulation,14(36%) cases with coarse long spiculation that pathologically correlated with thickened lobular septa infiltrated by inflammation; 13(33%) cases with vascular convergence found normal vessels going into the nodule;13(33%)with pleural indentation;13(33%) cases with satellites were surrounded by granuloma or caseous focus; In 16(41%) cases with inhomogeneous attenuation,12(30.7%) calcification and 6(15%) cavitation usually concentric, fissure and smooth inner wall were showed on CT.Conclusion HRCT of SPN can accurately reflect the edge and internal characteristics and play an important role in differential diagnosis of SPN.

关 键 词：肺结节 结核球 高分辨率CT 病理 

分 类 号：R814.42[医药卫生—影像医学与核医学] R563.1[医药卫生—放射医学]