双期CT增强诊断肺硬化性血管瘤

Diagnosis of pulmonary sclerosing hemangioma with incremental dynamic CT

目的分析肺硬化性血管瘤的CT表现,提高诊断与鉴别诊断能力。方法 13例经手术病理证实为肺硬化性血管瘤患者的CT、病理及临床资料。结果常规体检发现6例,上呼吸道感染就诊发现3例,术前常规发现3例,肺癌手术发现1例,痰中带血就诊发现1例。CT典型表现为肺内单发软组织肿块或结节影,呈圆形或类椭圆形,边缘光滑、密度均匀,平扫CT值(23±4)Hu,增强后动脉期(93±11)Hu,静脉期(112±15)Hu,增强扫描呈持续性强化为其特点。结论肺硬化性血管瘤少见,女性好发,临床无特殊症状,CT平扫结合双期增强扫描有助于肺硬化性血管瘤的诊断与鉴别诊断。

Objective To explore the value of incremental dynamic CT in the diagnosis of patients with pulmonary sclerosing hemangioma （PSH）. Methods The clinical features, radiographic manifestations of 21 patients with PSH were reviewed. Results 6 cases of PSH were confirmed by conventional physical examination, 3 cases through the diagnosis of upper respiratory infection, 3 cases due to other reasons by operation, 1 case through the surgery of lung cancer, and 1 from blood-stained sputum. The CT examination generally revealed the peripherally solitary, well-circumscribed, and round or similarly round nodule with homogeneous density. The average CT value was 23 ±4 Hu, and the enhanced CT scan showed continuous progressive enhancement with the value of 93 ± 11 Hu in the arterial phase and 112 ± 15 Hu in the venous phase. Conclusion PSH is a rare kind of disease and it mostly occurs in female without particular clinical symptoms. Dynamic contrast enhanced CT can be helpful in the diagnosis of sclerosing hemangioma.