肺硬化性血管瘤的CT表现及误诊分析

CT and pathological features of pulmonary sclerosing hemangioma and analysis of misdiagnosis

目的探讨肺硬化性血管瘤的CT表现,以提高诊断准确性。方法收集19例经病理证实的肺硬化性血管瘤的临床、病理及CT资料。结果 19例肺硬化性血管瘤共22个病灶。中央型1例,周围型18例,其中肺门旁3例,外围15例。多发毛玻璃密度1例,软组织密度18例。18例边缘规整,7例可见浅分叶征,4例密度不均匀。8例不均匀强化,其中明显强化者10例,中度强化者6例,轻度强化者3例,10例可见贴边血管征,4例可见晕征,1例可见空气新月征,5例内可见点状钙化。右肺上叶4例,右肺中叶2例,右肺下叶5例,左肺上叶1例,左肺下叶3例,跨叶分布2例,多发2例,2例伴纵隔淋巴结肿大。结论肺硬化性血管瘤的CT表现具有一定特征,结合临床发病年龄、性别、病理学特征等,有助于减少误诊。

Objective To investigate the CT features of pulmonary sclerosing hemangioma （PSH） so as to improve the accuracy of diagnosis of this condition. Methods Clinical, pathological and CT data of 19 cases of pulmonary sclerosing hemangioma diagnosed pathologically were collected. Results 22 PSH lesions of 19 cases were proved, including 16 females and 3 males. Of 19 cases, 1 case was central type and 18 cases showed peripheral types including 1 hilar lesion and 17 cases around hilum of lung. 1 case appeared multiple ground-glass-like density and 18 cases showed soft tissue density. 18 cases showed regular edge and 7 cases had slight lobulated sign, 4 cases showed uneven density and 8 cases appeared heterogeneous enhancement, in which marked enhancement was seen in 10 cases and moderate enhancement was seen in 6 cases, and 3 cases showed mild enhancement. Blood vessel marginating signs were observed in 10 cases and halo signs were seen in 4 cases. 1 case presented air meniscus sign and 5 cases showed punctuate calcification. 4 were located in right upper lobe, 2 located in right middle lobe and 5 located in right lower lobe. 1 was located in left upper lobe, 3 located in left lower lobe and 2 cases located in translobes. 2 cases showed multiple lesions, and 2 cases were accompanied mediastinal lymphadenectasis. Conclusion The CT features of pulmonary sclerosing hemangioma have certain characteristics. Based on patients＇ age, gender, pathological features, the misdiagnosis will be reduced.