肺硬化性血管瘤的MSCT诊断

MSCT Diagnosis of Pulmonary Sclerosing Hemangioma

目的:探讨肺硬化性血管瘤的MSCT表现特点,以期提高影像诊断准确率。方法:回顾性分析19例经手术及病理证实的肺硬化性血管瘤的患者资料,女性18例,男性1例,平均年龄为52.5岁;采用16层螺旋CT扫描仪,120kV,160 mAs,层厚5mm,层间距5mm,高压团注非离子型对比剂100ml(300mg/ml)增强扫描,流速2.5ml/s,延迟30s扫描,回顾性1.5mm薄层重建及多平面重组(MPR)分析。结果:全部为单发实性类圆形肺结节或肿块,最大径67mm,平均直径23mm,分布无偏向性,边界清晰。8例(42.1%)见斑点状钙化灶,4例(21.1%)见分叶征,3例(15.8%)见空气新月征,4例(21.1%)病灶跨叶间胸膜生长,1例(5.26%)见胸膜牵拉凹陷,8例(80%)增强CT扫描均显示贴边血管征。结论:肺硬化性血管瘤多见于中年女性,表现为肺内单发结节或肿块,MSCT表现有一定的特点,病灶可跨叶间裂生长,明显强化及贴边血管征有助于本病的诊断。

Purpose：The purpose of this study was to analyze the MSCT features of pulmonary sclerosing hemangiomas （PSHs）,and to improve the diagnostic accuracy of PSHs.Methods：Nineteen patients with proven PSHs by surgery and histopathology were reviewed,including 18 females and 1 male,and their mean age was 52.5 years old.They were undergone 16-slice spiral CT scanning with the following acquisition parameters：120 kVp,160 mAs,5-mm slice thickness,and 5-mm slice interval.Enhanced scan was examed after high-pressure injection of 100 ml non-ionic contrast agent （300 mg/ml） with a flow rate of 2.5 ml/s,and a 30s delay time.When images were reviewed,the 1.5-mm thickness images were reconstructed with method of multiplanar reformation （MPR）.Results：All PSHs in our study presented as solitary pulmonary nodules or masses with a maximum diameter of 67mm and mean diameter of 23mm.The incidence was equal in each lung lobe.Most PSHs were well-circumscribed.Eight cases （42.1％） were with calcifications.Four cases （21.1％） were with lobulations.Three cases （5.8％） were with air meniscus signs.Four PSHs （21.1％） were with the tendency to grow across the pleural membranes.And only 1 case （5.26％） showed pleural indentation sign.Eight cases （80％） on contrast enhanced CT scan images showed vascular welt signs.Conclusion：The PSHs often occur as isolated pulmonary nodules or masses in middle-aged females.The MSCT manifestations had certain characteristics.The lesions may grow across the pleural membranes.Evident enhancement and welt vessel signs may contribute to the diagnosis of PSHs.