HRCT联合MPR二次重建诊断肺硬化性血管瘤的价值

The Value of HRCT and Second Reconstruction of MRP of Pulmonary Sclerosing Hemangioma

目的:分析PSH的HRCT及MPR二次重建图像,提高本病的影像学检查、诊断及鉴别诊断能力。材料与方法:本组10例均经手术后病理证实,均作平扫加增强扫描、回顾性MPR及二次重建。结果:10例均为单发病灶,外周肺内8例;病灶直径多在2-3cm左右。病灶呈圆形6例,椭圆形3例;边界清晰、锐利8例,其中5例边缘光整;浅分叶2例,其中1例见"晕征";病灶内部密度较均匀4例,不均匀3例,3例见钙化;增强后均有明显强化,CT值增加40Hu以上,花斑样强化4例,较均匀强化4例,病灶中部囊变、周围明显强化2例;MPR二次重建清晰显示"贴边血管征"7例,未见周边血管受侵征象及"空气新月征";结论:PSH在HRCT上有较为特征的表现,"贴边血管征"显示率远高于"空气新月征",应用MPR二次重建,更加清晰、直观显示病灶周围结构、内部细节,有助于显示较特异征象,明显提高本病的确诊率及鉴别诊断能力。

Purpose： To evaluate CT characteristics of pulmouary sclerosing hemangioma （ PSH ） so that to improve the diagnosis of this disease. Materials and Methods： CT characteristics of PSH pathologically verified were retrospectively analysed . Conventional scan and contrast-enhanced scan were performed in all the patients. Results： all of these 10 cases had isolated mass. Diameters of these lesions ranged from 2 to 3cm. Of all cases, 8 cases were located in peripheral lung tis- sue, 6 cases were round and 3 lesions were oval, 8 cases were smooth margin, 2 cases were lobulated, and the halo sign in 1 case. Three cases contained nodular calcification, the remaining 4 cases were homogeneous density. All of these cases showed marked enhancement and average CT value of 40Hu was increased, 4 cases showed homogeneous enhancement, 2 ca- ses were cystic and peripheral enhancement. The welt vessel sign was in 8 cases of MPR without the air meniscus sign. Con- clusion： The welt vessel sign is the characteristic of PSH on HRCT, which can been seen more often than the air meniscus sign. MPR help to show the specific sign, significantly improve the ability of the diagnosis of this disease.