成人肺隔离症影像诊断

Imaging findings of adult pulmonary sequestration

目的:分析成人肺隔离症影像特点,提高对本病影像学诊断的认识,减少临床误诊。方法:回顾分析7例被血管造影或手术证实的成人肺隔离症的临床及影像学资料。结果:7例均行胸部平片及MSCT检查,2例行胸主动脉插管造影,5例行肺叶切除术。7例均为肺叶内型,6例位于左下肺后基底段,1例位于右下肺内基底段。病灶以不规则软组织块影为主4例,3例为多发囊性病变伴斑片状影,相邻肺野见斑点状影6例,肺野透亮度增高3例,肺纹理走向异常2例,5例CT见粗大扭曲的供血血管与降主动脉相连。结论:MSCT可以判断病灶的位置及范围,了解是否合并感染,MSCT增强显示其异常供血动脉可以明确诊断,是肺隔离症临床的首选检查方法。

Objective： To analyze the imaging findings of adult pulmonary sequestration to improve understanding and reduce misdiagnosis of this disease.Methods： Clinical data and imaging manifestations were retrospectively analyzed in 7 adult cases with pulmonary sequestration confirmed by angiography or postoperative pathology. Results： Seven cases received plain chest X-ray and multi-slice computer tomography（ MSCT） examination,and 2 were given additional angiography of the thoracic aorta. Five cases were undergone pulmonary lobectomy. The total 7 were cases of intralobar pulmonary sequestration,in which 6 occurred in posterior basal segment of left lower lung and 1 in medial basal segment of right lower lobe. X-ray findings demonstrated that 4 cases were irregular soft tissue mass,3 multiple cystic with patchy shadows,6 mottled shadow at the adjacent lung field,3 transparency enhancement of lung and 2,abnormal lung texture. CT results revealed that 5 were twisted lesion blood vessels connected to descending aorta. Conclusion： MSCT can expose the location and extent of lesion as well as presence of absence of lung infection,and clearly show the anomalous feeding artery,which suggest that MSCT is worthy of wider clinical recommendation in diagnosis of pulmonary sequestration.