无典型钙化征象的肺错构瘤的CT诊断

CT diagnosis of pulmonary hamartoma without typical calcifi ed signs

目的:总结无典型钙化征象的肺错构瘤的CT特征,以提高临床的诊断正确率。方法:回顾性分析2008年6月-2013年10月本院经手术病理证实的11例肺错构瘤影像学资料,10例行动态增强CT扫描,1例行普通CT扫描。结果:11例病灶位于右肺7例,左肺3例,气管内1例。病灶大小0.7 cm×0.7 cm^3.0cm×2.5 cm,平均直径1.8 cm。3例可测及脂肪密度,6例为软组织密度,所有病灶均未测及钙化密度。6例有分叶征,均无毛刺、胸膜凹陷征、血管集束等恶性征象。动态增强,9例强化值<20 HU,1例强化值在30~40 HU之间。结论:无典型钙化征象的肺错构瘤形态学上表现为良性肿瘤特征,分叶征较为常见,易误诊为肺癌,借助薄层CT扫描,可发现病灶内部细小的脂肪成分,有助于明确诊断。

Objective： To summarize the CT features of pulmonary hamartoma without typical calciifed, in order to improve the clinical diagnostic accuracy.Methods： Retrospective analysis with 11 cases of pulmonary hamartoma conifrmed by pathologically from June 2008 to October 2013. Ten patients underwent dynamic con-trast-enhanced CT scans, 1 patient underwent ordinary routine CT scan.Results： A total of 11 cases of which 7 cases occurred in right lung, 3 cases in left lung, 1 case in the trachea. the tumor size range from 0.7 cm × 0.7 cm to 3 cm × 2.5 cm, with an average diameter of 1.8 cm. Fat density could be detected in 3 cases, 6 cases showed the soft tissue density. Calciifcation density couldn’t be measured in all lesions. Six cases of nodules showed the lobulation sign, but all of the tumors showed no spiculation sign and no pleural indentation sign and no vascu-lar convergence sign. After dynamic enhancement, 9 cases enhanced CT values were less than 20 HU, 1 case enhanced CT values between （30-40） HU.Conclusion： The pulmonary hamartoma without typical calciifed shows the benign tumor characteristics. The lobulation sign is relatively common, so it is easily be misdiagnosed as lung cancer, in thin slice CT scan, the small fat particles can make a deifnite diagnosis.