肺上皮样血管内皮瘤的CT及PET/CT表现

CT and PET/CT findings of pulmonary epithelioid hemangioendothelioma

目的:分析肺上皮样血管内皮瘤(Pulmonary epithelioid hemangioendothelioma,P-EHE)的CT及PET/CT表现,提高对该病的诊断准确性。方法:回顾性分析本院7例经病理证实的P-EHE的临床及CT、PET/CT资料,并根据影像表现将其分为中央型和周围型。结果:7例患者中5例行CT平扫及增强扫描,1例行PET/CT检查,1例行CT和PET/CT检查。CT表现:中央型1例,表现为支气管内结节;周围型6例,表现为多发结节伴或不伴有肿块,其中伴有肿块者4例,单纯结节者2例,伴有磨玻璃密度影2例,点状钙化3例,胸膜增厚并胸腔积液2例,气胸1例。结节多分布于肺野中外带及胸膜下,与邻近支气管血管束关系密切。PET/CT表现:2例患者均表现为周围型伴肿块,肿块均表现为放射性摄取升高,部分结节SUV值不同程度升高,其中1例发现左下胸膜、纵隔及腹膜淋巴结、心包、腰椎及右侧髂骨放射性摄取增高。结论:P-EHE部分病灶有特征性表现,对于术前诊断有很大的帮助。

Objective:The CT and PET/CT findings of pulmonary epithelioid hemangioendothelioma(P-EHE)were analyzed to improve the diagnostic accuracy of the disease.Methods:The clinical,CT and PET/CT data of 7 cases of pathologically diagnosed P-EHE were analyzed retrospectively,according to the image manifestation,we divided the lesions into central type and peripheral type.Results:Of the 7 cases,5 cases underwent CT plain scan and enhanced scan,1 case underwent PET/CT and 1 case underwent CT and PET/CT.CT findings:central type in 1 case,showing endobronchial nodules.Peripheral type in 6 cases,showing multiple nodules with or without mass,including masses in 4 cases,simple multiple nodules in 2 cases,ground-glass opacity in 2 cases,punctate calcification in 3 cases,pleural thickening with pleural effusion in 2 cases,pneumothorax in 1 case.Nodules were mostly distributed in the outer zone of the lung field and under the pleura,and were closely related to the adjacent broncho-vascular tracts.PET/CT findings:2 cases showed peripheral type with masses,which showed increased radioactivity uptake and increased SUV values in some nodules,of which 1 case found increased radioactivity uptake in the left lower pleura,mediastinal and retroperitoneal lymph nodes,pericardium,lumbar vertebrae and right ilium.Conclusion:Some lesions of P-EHE have characteristic manifestations,which is very helpful for preoperative diagnosis.