CT肺动脉造影在诊断原发性肺动脉肿瘤中的应用

The Evaluation of CT Pulmonary Angiography in Diagnosis of Primary Pulmonary Artery Trunk Tumor

目的分析原发性肺动脉肿瘤的CT肺动脉造影(CTPA)表现并复习文献,以期提高肺动脉肿瘤的诊断正确率。资料与方法对4例经手术、病理证实的原发性肺动脉肿瘤(纤维肉瘤、低度恶性肌纤维母细胞肉瘤、平滑肌肉瘤、恶性间叶细胞瘤各1例)进行回顾性分析。4例均于术前行CTPA检查,其中1例术前CTPA检查2次。结果3例首次CTPA检查作出正确诊断;另1例首次CTPA诊断为肺动脉栓塞,经溶栓治疗后复查CTPA显示病变进展而诊断为原发性肺动脉肿瘤。结论原发性肺动脉肿瘤属于少见疾病,术前诊断困难,准确认识其CTPA征象并结合临床资料对提高诊断正确率非常重要。

Objective To analyze the manifestations of computed tomography pulmonary angiography （CTPA） of the primary tumors of pulmonary artery and review the literatures, in order to improve the diagnostic accuracy for the tumors of the pulmonary artery. Materials and Methods 4 cases with primary tumors of pulmonary artery （including fibrosarcoma, mild-malignant myofibroblastosarcoma, leiomyosarcoma and malignant stromal tumor） were analyzed retrospectively. All of the 4 cases were performed with CTPA examination before operation, of which one case was taken CTPA twice before operation. Results 3 cases were diagnosed initially accurately by CTPA, the other one case was diagnosed as pulmonary embolism in the first CTPA and sequentially was diagnosed as primary tumors of pulmonary artery when the development of clinical presentation was occurred after thrombolysis theraphy. Conclusion The primary tumors of pulmonary artery are rarely disease and are difficult to be diagnosed before operation, it is important to recognize its CTPA manifestations and integrate with the clinical information for improving the accuracy of the diagnosis.