摘要:
目的:探讨肺硬化性血管瘤(PSH)的多层螺旋CT(MSCT)表现,并对照病理结果进行分析,以提高对其认识及影像诊断水平。方法:回顾性分析39例经病理确诊的PSH患者的CT征象,3例仅行胸部CT平扫,余36例行CT平扫和增强。结果:男6例,女33例,平均年龄(46.9±14.36)岁,均为单发病灶,左肺19例,右肺20例。周围型30例,中央型9例,胸膜下32例(15例宽基底贴于胸膜),非胸膜下7例。病灶最大径5~57 mm,呈类圆形或卵圆形,边界清晰,11例边缘见浅分叶。平扫33例密度较均匀,6例欠均匀,平均CT值(34.0±13.4)HU,12例内见钙化。增强扫描多为中等至明显强化(30例),22例强化较均匀,14例强化不均匀,其中4例见低密度坏死区。动脉期平均CT值(77.0±25.6)HU,静脉期病灶呈渐进性或持续强化,平均CT值(91.0±17.1)HU。贴边血管征30例,周围磨玻璃密度影4例。结论:PSH的MSCT表现中贴边血管征、周围GGO征、显著肺动脉征、空气新月征及尾征,具有相对特征性,有助于提高术前的诊断准确性。
Abstract:
Objective: To investigate the MSCT imaging features of pulmonary sclerosing hemangioma(PSH) and comparison with the pathologic features, so that to improve the understanding and imaging diagnostic abilities of PSH. Methods: MSCT images of 39 cases with pathologically confirmed PSH were retrospectively reviewed.3 patients experienced only chest CT plain scan while the remained underwent both pre-and post-contrast CT scan. Results: This study comprised 6 male and 33 female with an average age of(46.9 ± 14.36) years. MSCT demonstrated all cases had solitary lesion, including 19 cases in the left lung and 20 in the right. 30 cases were peripheral and 9 were central. 32 cases demonstrated as subpleural lesions, 15 of which sticking to pleural with wide base; while 7 were non-subpleural. PSHs manifested as well-defined, round or ovoid nodules or masses, with a largest diameter ranged 5~57 mm. 11 cases presented slight lobulation. On pre-contrast CT, the density was homogeneous in 33 cases while heterogeneous in 6, with mean CT value of(34.0 ± 13.4)HU. Calcification was visible in 12 cases. After administration of contrast media, 30 lesions exhibited moderate or markedly enhancement, including 22 homogeneous and 14 heterogeneous. Hypodense necrotic area was presented in 4 lesions. The CT attenuation value in arterial phase was(77.0 ± 25.6)HU, and(91.0 ± 17.1)HU in venous phase during when gradual and continuous enhancement was found in 18 cases. Welt vessel sign(30 cases) and surrounding ground-glass opacity(4 cases) were also demonstrated. Conclusion: PSH MSCT findings of welt blood vessels sign、surrounded GGO sign, significant pulmonary artery sign, air crescent sign, tail sign has, which can help improve the preoperative diagnostic accuracy.
百度学术
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