肺硬化性血管瘤的CT表现及病理基础

CT manifestations and pathological basis of pulmonary sclerosing hemangioma

目的探讨肺硬化性血管瘤（PSH）CT表现特点,提高PSH的诊断准确率。方法回顾分析经病理确诊为PSH的10例患者的影像检查资料。10例患者均行胸部CT平扫,6例行增强CT。结果 10例患者共11个病灶,左肺6个,右肺5个,病灶均呈类圆形肿块或结节,边缘清楚,直径1.2～8.6cm,9个病灶直径小于3.0cm,3例周边有分叶,3例与胸膜粘连,7例密度均匀,CT值26～53Hu,平均32.6Hu,3例可见点状钙化,2例周边见空气新月征。注射造影剂后,6例病灶强化明显,大小3.2～7.5cm,平扫呈稍高密度,增强扫描轻、中度强化（CT值59～86Hu）,2例见贴边血管征。结论 PSH多呈球形或类圆形,密度偏高且较均匀,边缘光滑锐利,病灶内可见空气新月征,增强扫描强化明显,并可见贴边血管征;多数病灶术前可以诊断,少数确诊仍需病理检查证实。

Objective To study the CT features of pulmonary sclerosing hemangioma（PSH）to improve the accurate diagnostic rate.Methods CT image data of 10cases with PSH were retrospectively analyzed.All of the 10cases underwent plain chest CT scan,and 6cases underwent plain and enhanced CT scan.Results In all of the 10cases,there were 11lesions,including 6lesions located in left lung and 5lesions located in right lung.All lesions were mass or nodule in shape of round,with smoothly margin and diameter of 1.2-8.6cm.Diameter of 9lesions were less than 3.0cm.3lesions were with lobule.Pleural synedhia were in 3lesions.Densities of 7lesions were uniformity,with CT value of 26-53Hu and average value of 32.6Hu.Calcification like sand could identified in 3lesions.Air meniscus sign could be found in 2lesions.After injection of contrast medium,6lesions showed obviously enhancement,CT value of which increased to 59-86 Hu.Blood vessel marginating could be observed in 2lesions.Conclusion PSH could have certain CT features.If these features are found in middle-aged and elderly women,PSH should be considered and diagnosed by pathology detection.