肺硬化性血管瘤的CT诊断

The CT diagnosis of pulmonary sclerosing hemangioma

目的:探讨肺硬化性血管瘤(PSH)的CT特征,提高诊断水平。方法:回顾性分析12例经手术与病理证实的PSH临床资料和CT表现。结果:12例PSH均为单发病灶,中央型3例,周围型9例,发生于右肺7例,左肺5例,9例位于胸膜下,肿瘤大小7mm×8mm^50mm×45mm。CT平扫12例PSH均表现为边界清楚密度均匀的圆形卵圆形软组织密度肿块,3例见"尾征",2例见"晕征",1例见"胸膜凹陷征",1例见"浅分叶征",3例病灶边缘部分见沙粒状钙化,12例PSH均未见"毛刺征"。增强扫描肿瘤呈持续性进行性显著强化,动脉期、实质期CT值比平扫平均增加35 HU和65HU。7例PSH动脉期见"贴边血管征"。结论:肺硬化性血管瘤的CT表现有一定特征性,CT扫描特别是增强检查能为诊断提供重要依据,明确诊断需病理学检查。

Objective：To summarize the CT image features of pulmonary sclerosing hemangioma（PSH）,so as to improve the CT diagnostic quality to PSH.Methods：12 cases with PSH proved by surgery and pathology were enrolled.Results：The CT findings of 12 cases including 2 males and 10 females,showed all single lesion,of which 3 were central type,9 were peripheral type,7 were located in right lobe,5 located in left lobe,9 located under pleura,the diameters were 7mm×8mm～50mm×45mm.The CT non-contrast scans of 12 cases demonstrated isolated round or oval soft tissue masses with clear boundary and homogeneous density,3 cases with tail signs,2 cases with halo signs,1 case with depressed pleura signs,1 case with slight lobulation,3 cases with calcification like sand in margin.None of the 12 cases showed spicula sign.The enhanced CT scan showed continuous progressive enhancement and the CT values in carterial phase and parenchymal phase increased for 35HU and 65HU respectively.Blood vessel marginating signs were observed in the arterial phase in 7 cases.Conclusion：The CT image features of PSH have some characteristic and the enhanced CT scan could be helpful in diagnosis of PSH to some extent,but the definite diagnosis should be according to the pathology.