肺错构瘤的影像诊断

Imaging diagnosis of pulmonary hamartoma

目的 :分析肺错构瘤的影像学特征及鉴别诊断。方法 :搜集 1 999年～ 2 0 0 1年间经手术及病理证实的肺错构瘤患者 1 5例 ,其中男 9例 ,女 6例。胸片检查 9例 ,CT扫描 6例 ,其中平扫 3例 ,增强扫描 3例。结果 :主气管病变 1例 ,中央形病变 2例 ,周围型病变 1 2例。右肺结节 1 1例 ,左肺结节 3例。病灶内钙化 3例 ,有钙化和脂肪 2例 ,均匀密度无钙化及脂肪 1 0例。病变直径 1～ 5cm。病变直径≤ 3cm 1 1例 ,占 73 .3 %。光滑圆形孤立结节 1 1例 ,浅分叶及不规则形状 4例。3例行CT增强扫描均无明显强化。本组肺错构瘤中 33 .3% (5/ 1 5)为典型错构瘤影像学表现 :小结节直径≤ 3cm ,边缘光滑 ,病灶内可见钙化和 /或脂肪。非典型表现为 66 .7% (1 0 / 1 5) ,包括大结节、浅分叶和不规则结节 ,结节均匀密度及位于主气管内。结论 :爆米花样钙化和脂肪密度为肺错构瘤的典型征象。

Objective:To analyze the imaging manifestations and differentiated diagnosis of pulmonary hamartoma.Methods:15 cases with surgically and pathologically proved pulmonary hamartoma enrolled during 1999～2001 were studied ,including 9 men and 6 women.They were performed chest film in 9 cases,plain CT scan in 3,and enhanced CT in 3.Results:There was tracheal involvement in 1 case,central type 2 cases,and peripheral lesions 12 cases.The lesion of 11 cases was found in right lung and 3 cases in left lung.Of them,calcification was seen in 3 cases,both calcification and fatty density in 2 cases,homogenous density in 10 cases.The maximal size of the lesion was 5cm,and the minimum 1cm.The lesion was less than 3cm in 11 cases(73.3%).Smooth solitary nodules were found in 11 cases and shallow lobulated or irregular shape in 4 cases.Three cases in enhanced CT showed non inhancement.Of all pulmonary hamartoma,typical imaging findings are seen only in a few (33.3%) cases such as the small pulmonary node with the diameter ≤3cm,smooth edge,with calcification and/or fat in the lesion.Conclusion:Typical imaging findings of pulmonary hamartoma were popcorn culcitication and /or fatty.CT is helpful to differenticate atypical findings of pulmonary hamartoma from other solid pulmonary nodules