肺错构瘤CT征象分析及鉴别

Analysis and identification of CT signs of pulmonary hamartoma

目的探讨肺错构瘤的CT征象特点,提高鉴别诊断能力。方法回顾性分析19例经手术病理确诊为肺错构瘤的CT图像,并分析各种征象的特点。结果19例肺错构瘤均为单发病灶,16例位于右肺(84.21%),左肺3例(15.79%)。结节呈浅分叶17枚(89.47%),呈圆形/类圆形改变15枚(88.24%),边缘光整16枚(84.21%),结节内钙化18枚(94.74%),其中爆米花样钙化10枚(55.56%),结节状钙化8枚(44.44%);15枚可测得明显的脂肪密度(78.95%)。1例结节邻近胸膜增厚(5.26%),3例结节与肺门之间有粗细不均的索条影相连(15.79%)。纵隔肺门淋巴结肿大并钙化1例(5.26%),CT增强显示肺动脉绕行结节,未见明显供血动脉。5例中4例轻度持续强化,1例中度强化。结论肺错构瘤CT表现具有较强的特征性,综合分析其CT特征有助于提高诊断符合率,减少误诊。

Objective This study aims to investigate CT sign characteristics of pulmonary hamartoma to increase the dif‐ferential diagnosis ability .Methods A retrospective analysis was conducted for CT images of 19 cases of patients with pulmonary hamartoma confirmed by surgical pathology ,and characteristics and occurrence frequency of various signs were concluded and analyzed .Results All 19 cases of pulmonary hamartoma were of single lesion .Sixteen cases occurred in the right lung （84 .21% ） ,and 3 cases occurred in the left lung （15 .79% ） .For nodules ,17 pieces presented shallow lobula‐tion change （89 .47% ） ; 15 pieces presented round/round‐like change （88 .24% ） ; 16 pieces presented smooth edge （84.21% ） ; 18 pieces presented nodular calcification （94 .74% ） , including 10 pieces of popcorn‐like calcification （55.56% ） and 8 pieces （44 .44% ） of nodositas calcification ;15 pieces presented detectable obvious fat density （78 .95% ） . One case presented nodule‐adjacent pleural thickening （5 .26% ） ,and 3 cases presented uneven thickness of linear opacity connection between nodule and hilus pulmonis （15 .79% ） .In addition ,1 case presented mediastinal lung lymph node en‐largement accompanied with calcification （5 .26% ） ,and 19 cases presented no pleural effusion ;CT enhancement showed pulmonary artery running around nodules and no obvious blood supply arteries .Among 5 cases of enhancements ,4 cases of mild enhancements constantly strengthened （enhancement value ：10 ~ 20 HU ） ,and there was 1 case of moderate en‐hancement （enhancement value ：21 HU） .Conclusion CT manifestations of pulmonary hamartoma have stronger charac‐teristics ,and a comprehensive analysis of CT characteristics helps to improve the diagnostic accordance rate and to reduce misdiagnosis .