肺淋巴管肌瘤病的多层螺旋CT影像诊断

The MSCT Diagnosis of Pulmonary Lymphangiomyomatosis

目的通过对多层螺旋CT（MSCT）常规层厚和薄层重组图像特征的分析,探讨其对肺淋巴管肌瘤病（PLAM）的影像诊断价值。资料与方法经肺组织活检病理证实的PLAM4例,均为女性,年龄28-62岁;采用16层螺旋CT扫描仪常规扫描层厚10mm,探测器开放1.25mm×8,横轴面薄层重组和冠状面、矢状面多平面重组（MPR）图像层厚1.3mm。结果双肺弥漫分布大小不等的类圆形囊腔影,常规层厚图像显示囊腔影的径线2-35mm,较小的囊腔影不能显示明确的薄壁,薄层重组和MPR图像显示囊腔影薄壁明确,壁厚〈2mm,囊壁上明确可见散在的血管断面影和血管穿插其中。1例伴有右侧胸膜腔少量积液,4例均不伴有其他部位淋巴管肌瘤改变。结论MSCT常规层厚图像发现可疑囊性病变,需进行薄层重组和MPR,对于弥漫分布的,厚度〈2mm的薄壁囊肿,其囊壁内见到小血管穿插其中,应高度怀疑PLAM的可能。

Objective To discuss the diagnostic value of MSCT in pulmonary lymphangiomyomatosis. Materials and Methods 4 cases of pulmonary lymphangiomyomatosis with pathologically proved were performed with 16 slice CT, conventional slice thickness was 10mm,detection collimation was 1.25 mm × 8 row,axial thin section and coronal and sagittal MPR image slice thickness was 1.3mm. Results MSCT Showed multiple diffuse lung parenchyma cysts, the diameter cyst of was 2 -35 mm in conventional slice thickness,thin wall of small cysts could not be seen,but thin section of reconstruction image and MPR image could depict thin wall of cysts, thickness of the wall was less than 2ram, also clearly showed sporadic vessels on cyst wall. 1 case accompanied with pleural effusion, 4 cases did not accompany with lymphangioleiomyomatosis in other sites. Conclusion Suspicious cyst lesion on conventional slice thickness image of MSCT needs thin-section reconstruction and MPR. Diffuse lung parenchyma cysts of thin wall less than 2mm with vessel on the wall cysts, pulmonary lymphangiomyomatosis should be highly suspected.