肺硬化性血管瘤的影像及病理学分析

The Imaging and pathology analysis of pulmonary sclerosing hemangioma

目的回顾性分析肺硬化性血管瘤(PSH)的影像及病理学特点,提高对PSH的影像诊断水平。方法收集2008年4月～2011年10月由病理证实的PSH共18例,女17例,男1例,年龄15～61岁,平均47岁。所有病例均行CT平扫,其中10例行CT增强扫描。影像学征象由两名资深胸部影像诊断医师共同讨论完成。结果 CT显示病变直径平均(3.0±1.8)cm,形状呈类球形11例(61%),不规则形7例(39%),所有病例均显示边缘光滑(100%);平扫2例(11%)病灶内有斑点状钙化,1例呈混合磨玻璃影,其余(83%)密度均匀,CT值为(40±15)HU;10例增强扫描中,6例显示均匀强化,强化净值为(30±23)HU;另4例呈明显不均匀的"花斑样"强化。结论以下指标有助于对PSH的诊断:①女性患者,边缘光滑的类球形或卵圆形肺结节,周围无毛刺及卫星灶;②CT平扫密度较均匀,有时呈磨玻璃影和内可见斑点状钙化,但边缘光滑;③增强呈均匀强化或"花斑"样强化。

Objective To retrospectively evaluate the diagnostic value of imaging with pathology for PSH. Methods 18 cases of PSH proved by operation and histopathology from April 2008 to October 2011 were collected, including 17 female and 1 male, their age from 15 year-old to 61 year-old, with an average age of 47 years. All the cases underwent CT scan, among them, 10 cases received enhanced CT scan. The imaging findings were summarized by two chest imaging physician. Results The average size was （3.0±1.8） cm. 11 cases （61%） were round in shape, 7 cases （39%） were irregular, and 5 cases were lobulated in these irregular. All cases （100 %） were smooth. On precontrast CT, the average CT value of 15 cases （83 %） was （40 ±15） HU, while punctiform calcification could be seen in 2 cases （11%） and mix ground-glass opacity could be seen in 1 case. The average absolute enhancement was （30±23） HU of 6 cases on enhanced CT scan,another 4 cases showed intense and heterogeneous enhancement. Conclusion PSH should be considered with the following features： （1） female patients well-defined round or oval shaped lesion; （2） a homogeneous soft-tissue mass on unenhanced CT： ground-glass opacity in the tumor and/or calcification can occasionally be found; （3） homogeneous or heterogeneous en- hancement after contrast administration.