肺隔离症的多层螺旋CT诊断

Multislice Spiral CT Diagnosis of Pulmonary Sequestration

目的:探讨总结肺隔离症的多层螺旋CT影像学特点以提高该病的诊断正确率。方法:回顾性分析经手术及病理证实的10例肺隔离症患者的CT影像并查阅、复习相关文献。结果:10例肺隔离症患者中,叶内型9例,叶外型1例。1例叶外型位于左肺下叶及左膈之间;9例叶内型均位于肺下叶内、后基底段,其中7例位于左下肺,2例位于右下肺。10例隔离肺均可见来自体动脉的供血动脉,其中3例来自腹主动脉,7例来自降主动脉。9例叶内型中其中1例为增多增粗异常血管结构。CT表现2例为实性肿块:为单发软组织肿块,边缘清楚,CT值48Hu^65Hu,增强扫描后明显强化;3例为囊实性肿块:表现为实性成分内见多个囊性区,囊性区内可见液体、气体影,实性成分不均匀强化,CT值约8-54HU;4例为囊状病灶:表现为薄壁囊性病灶,边界清,增强扫描见囊壁有强化血管;1例表现为增多增粗异常血管团:局部肺段血管增粗、增多、扭曲成团,病变周围可见纤维条索影。结论:肺隔离症具有特征性的CT征象,其中最关键的征象是异常体动脉供血血管的显示,多层螺旋CT增强扫描对该异常供血血管的显示具有明确性和特征性,在诊断肺隔离症方面具有重要价值。

Objective:To summarize the imaging characteristics of multi-slice spiral CT of pulmonary sequestration so as to improve the diagnostic accuracy of the disease.Methods:the CT images of 10 patients with pulmonary sequestration confirmed by operation and pathology were analyzed retrospectively,and the relevant literature was reviewed.Results:of the 10 patients with pulmonary sequestration,9 were intralobar and 1 was extralobar.1 case was located between the left lower lobe and the left diaphragm;9 cases were located in the lower lobe and the posterior basal segment,including 7 cases in the left lower lung and 2 cases in the right lower lung.Blood supply arteries from body arteries were found in 10 isolated lungs,3 from abdominal aorta and 7 from descending aorta.Among 9 cases of intralobar type,1 case was abnormal vascular structure.CT showed solid mass in 2 cases:single soft tissue mass with clear margin,CT value of 48 hu-65 hu,and obvious enhancement after enhanced scanning;cystic solid mass in 3 cases:multiple cystic areas were seen in solid components,fluid and gas shadows were seen in cystic areas,solid components were uneven and enhanced,CT value of about 8-54 hu;cystic lesions in 4 cases:The lesions were thin-walled cystic lesions with clear boundary.On contrast-enhanced scan,there were enhanced blood vessels on the wall of the capsule.In one case,there were increased and thickened abnormal blood vessels:local pulmonary segment blood vessels were thickened,increased and twisted into masses,and fibrous bands were seen around the lesions.Conclusion:pulmonary sequestration has characteristic CT signs,the most important sign of which is the display of abnormal blood supply vessels of body arteries.Multi-slice spiral CT enhanced scan is clear and characteristic for the display of abnormal blood supply vessels,and has important value in the diagnosis of pulmonary sequestration.