实性肿块型肺隔离症的CT诊断

CT Diagnosis of Solid Mass Type of Pulmonary Sequestration

目的探讨实性肿块型肺隔离症CT表现特点,以提高其诊断率。资料与方法回顾性分析9例经手术证实的实性肿块型肺隔离症患者的CT资料,观察病变的部位、形态、密度、边缘、与周围结构关系及其强化特点。结果9例中病变位于左下肺7例,右下肺2例;病变呈"珊瑚状"7例;密度不均匀9例,表现为多数囊样稍低密度区,增强后尤为明显;边缘光滑、清楚8例,模糊1例;病灶与主动脉分界清楚9例,相邻横膈面胸膜肥厚7例,呈肋骨样肥厚;动脉期病灶内可见多数扭曲、紊乱的血管影9例,可见明确供血动脉2例,肿块边缘及主动脉旁见圆形血管断面强化影9例。结论实性肿块型肺隔离症在发生部位、形态、密度、边缘、与周围结构关系及其强化特点上具有一定的特征性,对其CT表现全面分析能够提高术前诊断的正确率。

Objective To investigate CT appearance of solid mass type of pulmonary sequestration in order to improve its diagnostic accuracy. Materials and Methods The CT features of 9 cases with solid mass type of pulmonary sequestration confirmed by the surgery were analyzed retrospectively. The location, the shape, the density, the margin, periphery the structure relations and its the enhancement characteristic were observed. Results Among 9 patients, the pulmonary sequestration was in the left lower lobe in 7 patients and in the right lower lobe in 2 patients. The coral-like was found in 7 cases; the density was nonuniformity in 9 cases with multiple cystic hypodensity, the lesions were more obvious after enhancement ; edge was smooth in 8 cases, edge was fuzziness in 1 case; distinct margin with the aorta was found in 9 cases, the thickening of neighboring horizontal diaphragm surface pleural membrane was found in 7 cases. After enhancement, the most distortions disorder blood vessel was found in 9 cases in artery phase, obvious feeding artery was seen in 2 cases, the circular blood vessel around aorta and mass was found in 9 cases. Conclusion Solid mass type of pulmonary sequestration have some features in the location, the shape, the density, the edge, and the periphery structure relations and its enhancement characteristics, comprehensive analysis to its CT appearance can improve its diagnostic accuracy.