支气管内型错构瘤的临床影像分析

Clinical Imaging Analysis of Endobronchial Hamartoma

目的探讨支气管内型错构瘤(EH)的CT表现,以提高临床诊断的准确率,避免误诊。方法回顾性分析2012年1月至2019年8月郑州大学第一附属医院15例经病理组织学确诊的EH患者的临床及CT影像资料,观察并评估病灶的部位、数量、形态、直径、边缘、密度,分析病灶的强化方式、强化程度。结果本组患者男8例,女7例,年龄53~83岁,平均(63.07±9.65)岁,其中发热伴咳嗽3例,咳嗽咳痰8例(合并痰中带血2例),呼吸困难2例,胸痛1例,无明显症状体检发现1例。肿瘤位于左主支气管内4例,左下叶基底段支气管内1例,右主支气管内3例,右上叶尖段支气管内2例,右中叶支气管内4例,右下叶基底段支气管内1例。除1例病灶为多发外,其余均为单发。CT影像上6例呈均匀软组织密度,9例患者病灶内可见脂肪成分,其中7例病灶内既可见脂肪又可见钙化,8例病灶内无典型钙化及脂肪密度。8例行增强扫描,轻度强化4例,中度强化1例,无明显强化3例。结论EH的CT表现具有一定的特征性,多平面重组(MPR)有助于病灶的检出,观察病灶与支气管壁的关系,避免不必要的漏诊和误诊。

Objective To explore the CT and clinicopathological features of endobronchial hamartoma.so as to improve the accuracy of clinical diagnosis and avoid misdiagnosis.Methods The clinical and CT data of 15 patients with endobronchial hamartoma diagnosed by histopathology in the First Affiliated Hospital of Zhengzhou University from January 2012 to August 2019 were retrospectively collected.The location,quantity,shape,diameter,edge and density of the lesions were observed and evaluated and the enhancement mode and degree of the lesions wereanalyzed.Results There were 8 males(53.3%)and 7 females(46.7%)with an average age of(63.07±9.65)years,including 3 cases of fever with cough,8 cases of coughing sputum,2 cases of blood in sputum,2 cases of dyspnea,1 case of chest pain and 1 case of asymptomatic physical examination.The tumor was located in left main bronchus in 4 cases,left lower lobe basal segmental bronchus in 1 case,right main bronchus in 3 cases,right upper lobe apical segmental bronchus in 2 cases,right middle lobe bronchus in 4 case and Wright lower lobe basal segmental bronchus in 1 case.CT images showed homogeneous soft tissue density in 6 cases,fat components in 9 cases,fat and calcification in 7 cases,and no typical calcification and fat density in 8 cases.Contrast-enhanced scan was performed in 8 cases,including mild enhancement in 4 cases,moderate enhancement in 1 case and no obvious enhancement in 3 cases.Conclusion The CT findings of EH have certain characteristics.MPR reconstruction is helpful in detecting the lesions,observing the relationship between the lesions and the bronchial wall,and avoid unnecessary missed diagnosis and misdiagnosis.