儿童先天性肺囊性腺瘤样畸形的影像学诊断

Diagnostic imaging of children's congenital cystic adenomatoid lung malformation

目的探讨儿童先天性肺囊性腺瘤样畸形的影像学表现,提高对本病的认识。方法搜集23例经病理证实的儿童先天性肺囊性腺瘤样畸形患者的X线和CT资料,分析影像学特点,并与组织病理学资料作对照分析。结果 18例患儿胸片表现异常,其中气胸样改变9例,多囊状改变7例,肿块样实变1例,肺炎样改变1例,其中合并肺纵隔疝9例,出现患侧肺气肿16例;5例患儿胸片表现正常。CT表现为巨大囊腔7例,类圆形薄壁囊腔7例,蜂窝样小囊8例,肿块样改变1例,其中,3例可见液平面,右肺受累11例,左肺受累12例;Stocker分型I型15例,II型7例,III型I例。结论CT检查可作为诊断儿童先天性肺囊性腺瘤样畸形的可靠方法。

Objective To investigate the imaging features of children＇s congenital cystic adenomatoid lung malformation（CCAM）,and improve the recognition of the disease.Methods 23 children with pathological proved CCAM were reviewed rospectively and comparatively analysis between imaging and histopathology were made.Results Chest X-ray（CXR）showed an abnormality in 18 children,including pneumothoracic-like change in 9patients,vesicles appearance in 7patients,tumor-like change and pneumonia-like change in 1patient separately.9patients incorporated with pulmonary mediastinal hernia,and 16 patients with emphysema at the affected side;CXR was unremarkable in 5patients.On CT scan,7patients incorporated with large cysts,7patients had circular thin-walled cystic lesion,8patients had honey combing-like vesicles,1patient had tumor-like change,among in which 3patients had a few liquid.Right lung was implicated in 11 patients,left lung was implicated in 12 patients.According to Stocker classification,15 patients were typy I,7patients were typy II and 1patient was type III.Conclusion Imaging findings,especially CT scan,is a reliable indicator of resolution of the CCAM.