肺硬化性血管瘤增强CT表现与病理对照分析

Pulmonary Sclerosing Hemangioma:Enhanced CT Findings and Pathologic Correlation

目的研究肺硬化性血管瘤(PSH)增强CT表现及其与手术病理的关系,提高术前诊断准确性。方法搜集15例经手术病理证实的PSH患者,其中男3例,女12例,年龄24～75岁,平均年龄46.7岁,均行胸部X线平片及MSCT平扫加增强扫描,研究其平扫及强化特点并与病理结果对照。结果单发14例,多发1例,共16个病灶,结节(﹤3cm)9个,肿块(﹥3cm)7个。影像表现是孤立病灶,边缘光滑整齐,病变直径平均(3.2±1.4)cm,平扫CT值(41.6±16.3)Hu,增强扫描呈明显均匀或不均匀强化,动脉期强化净值(38.2±12.1)Hu,静脉期强化静值(55.5±10.8)Hu。结论边缘光滑的类圆形或椭圆结节,密度均匀或不均匀,增强后早期强化,且强化延续时间长为PSH强化特征,增强扫描尤其是薄层多期增强扫描对病变的诊断和鉴别诊断有重要价值。

Objective To Study the correlationship between enhanced CT features and pathologic result postoperativeiy of pulminary sclerosing hemangioma（PSH）,in order to improve the preoperative diagnosistic accurativity of PSH.Methods 16 PSH lesions of 15 cases,were proved by surgical or pathological.Including 3 males and 12 females,aged ranging from 24 to 75 years old,with an average 46.7 years old,were analyzed restrospectively.Radiographs,both plain and enhanced-contrast MSCT scanning were performed and imaging characteristics were explored in all cases,and then compared with its pathologic results.Results Of 16 PBH,14 cases were solitary and 1 was mulitiple（2 lesions）,including 9 nodules（3cm） and 7 mass（3cm）.All lesions were isolated,smoothly margined and with a mean diameter（3.2±1.4）cm,（41.6±6.3）Hu of pain scaning CT value and the net enchancement worth of（38.2±2.1）Hu of arterial phase and（55.5±0.8）Hu of venous phase.Conclusion PSH is characterized of a kind of nodule of round or oval shape,smooth margin,homogeneous or inhomogeneous density,early and persistent enhancement features.Enhanced CT scanning,especially multi-phase and lamellar enhanced-contrast scan shows great value on the diagnosis and differential diagnosis of PSH.