周围型肺错构瘤的影像表现

目的 探讨周围型肺错构瘤的影像表现，以提高诊断正确率。方法 回顾性分析经手术病理证实的22例周围型肺错构瘤的影像表现。胸片检查12例，CT扫描16例（其中6例同时有胸片）。结果 所有病例均为单发，右肺13例，左肺9例。全部错构瘤病灶均为边缘清楚、无毛刺或卫星病灶的肺内肿块，浅分叶5例，平片显示钙化3例，CT扫描脂肪成分和钙化的显示分别为8例和6例（其中2例呈典型的爆米花样钙化）。7例行CT增强扫描均无明显强化。结论 爆米花样钙化及脂肪密度是周围型肺错构瘤的特征性影像表现，薄层CT扫描尤其是HRCT检查能提高肺错构瘤的诊断准确率，增强CT扫描对错构瘤的鉴别诊断有一定的价值。     

肺错构瘤的影像诊断

目的：探讨肺错构瘤的影像诊断问题。方法：回顾性分析经手术病理证实的２６例肺错构瘤，所有病人均有Ｘ线平片，１１例体层及６例ＣＴ检查。并同４５例结核球和９８例周围性肺癌进行对照研究。结果：肺错构瘤的主要Ｘ线征象：中央型３例为叶支气管内或肺门区肿物，周围型２３例均为圆形或椭圆形肿块，病灶平均直径２．２ｃｍ，多数边缘光整，３５％病灶有钙化，以斑点状或环状多见。本病与结核球、肺癌在病灶的大小、边缘及密度等均有不同之处。本病ＣＴ表现病灶内常可显示钙化和脂肪。结论：传统Ｘ线对周围性错构瘤的诊断及其与结核球、周围性肺癌的鉴别很有帮助。ＣＴ检查可补充平片、体层之不足，可显示病灶内钙化或／和脂肪特征。     

周围型肺错构瘤的HRCT诊断

目的探讨周围型肺错构瘤的HRCT特征,并与常规胸部CT表现比较,提高诊断准确率。方法回顾性分析经手术及穿刺病理证实的15例肺错构瘤患者的CT资料。结果15例肺错构瘤发生于右肺者6例,左肺9例,均为单发,病灶大小自0.9cm×1.0cm～3.8cm×4.5cm不等。12例(80%)病灶靠近胸膜,呈圆形或椭圆形结节灶,边缘光滑清楚,多表现为均匀软组织密度,CT值平均为(39.6±13.2)HU,其中6例(40%)有脂肪成分,8例(33.3%)可见钙化。结论利用CT和HRCT可正确诊断具有一定特征表现的周围型肺错构瘤。     

肺错构瘤的多层螺旋CT诊断

目的分析肺错构瘤的CT表现,并提高其诊断准确性。方法 31例由病理证实的肺错构瘤患者均经16层螺旋CT胸部平扫与增强扫描。对所有患者肿瘤病灶的部位、形态、大小、数目及强化特征,进行了回顾性总结分析。结果 CT扫描证实,25例(81%)的错构瘤是肺内型,其中包括24例孤立型和1例多发型,4例合并周围型肺癌。另外6例(19%)的错构瘤是支气管腔内型。绝大多数(30/31)患者的肿瘤CT表现是以边缘光滑锐利的圆形或卵圆形、直径小于3 cm的肿块影为特征。此外,还可看到其他或多或少的伴发征象,诸如,规则的圆形或卵圆形结节(58%),不规则形结节(48%),软组织密度结节影(55%),钙化影(35%),以及脂肪密度影(13%)。在对比增强CT像上,所有错构瘤病灶均表现为轻度强化(强化值小于30 HU)。结论除钙化及脂肪密度外,边界清晰及增强后轻度强化是诊断肺内型错构瘤的重要依据。而支气管腔内结节出现钙化或脂肪密度则高度提示支气管腔内型错构瘤。     

肺错构瘤的CT表现及其与其他疾病的鉴别

目的分析肺错构瘤的MSCT表现及其与其他疾病的鉴别。方法对26例行MSCT检查并经手术和病理证实的肺错构瘤进行回顾性分析。结果本组26例均为单发肺错构瘤,其中22例为周围型,位于右肺12例,位于左肺10例;4例为腔内型,其中,1例位于气管中段腔内,1例位于左主支气管内,2例位于左肺下叶支气管内。病灶呈圆形或椭圆形,边缘锐利,9例显示有浅分叶,但均无毛刺。本组22例周围型错构瘤中,3例病灶内含有脂肪密度影;9例病灶内含有钙化影,其中3例为典型的爆米花样钙化;10例病灶呈均匀软组织密度影。4例腔内型错构瘤中,3例病灶内含有脂肪成分,1例含有钙化影。本病主要需于肺炎性假瘤、小叶癌、结核瘤相鉴别。结论肺错构瘤的MSCT表现有一定特征,病灶边缘清楚,内含有脂肪和钙化有助于正确诊断。     

肺错构瘤的影像诊断

目的：分析肺错构瘤的影像学特征及鉴别诊断。方法：搜集1999年～2001年间经手术及病理证实的肺错构瘤患者15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12例。右肺结节11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10例。病变直径1～5cm。病变直径＜3cmll例，占73．3％。光滑圆形孤立结节11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。本组肺措构瘤中33．3％(5／15)为典型措构角影像学表现：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％(10／15)，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。CT检查有助于鉴别非典型表现和肺内孤立性结节。     

肾错构瘤的CT诊断

目的：分析总结了19例错构瘤的CT表现，以提高肾错构瘤的CT诊断率。方法：双肾常规平扫增强，层厚5mm，螺距1．5：1，可疑小病灶拆薄后重建处理。结果：含脂肪组织较多的肿瘤14例；少脂或无脂肿瘤5例。拆薄后重建发现两例病灶未能发现的脂肪成分，一例可疑小病灶证实为病变。结论：含脂较多的错构瘤有典型的CT表现，诊断容易。少脂或无脂的错构瘤及细小病灶经拆薄重建后能提高诊断率。     

周围型肺错构瘤的HRCT表现与病理对照研究

目的：探讨周围型肺错构瘤的ＨＲＣＴ特征及其病理基础,以期提高诊断准确率。材料和方法：回顾性对照研究２５例经手术和病理证实的周围型肺错构瘤的ＨＲＣＴ及其病理表现。结果：所有肺错构瘤均单发,右肺１４例,左肺１１例;２４例病灶贴近胸膜（９６％）,距胸膜平均距离为０．６４ｃｍ。余１例距胸壁为４．４ｃｍ。病灶呈圆形或椭圆形,边缘清晰镜利,１２例见分叶征（４８％）,７例见一条血管影进入病灶（２８％）。ＨＲＣＴ显示４例含脂肪成分（１６％）,９例有钙化（３６％）（其中４例为爆玉米花样钙化）。术前ＨＲＣＴ诊断正确者１６例（６４％）。病理上所有病灶均有完整的纤维包膜,２３例（９２％）见软骨、腺体、平滑肌和纤维结缔组织等结构,１１例（４４％）见不同程度的脂肪发,８例（３２％）见不同程度的钙化。结论：周围型肺错构瘤的ＨＲＣＴ表现有一定     

肺棘球蚴病的CT诊断

目的分析肺棘球蚴病的CT表现,评价CT检查的价值.方法23例经手术病理证实为肺棘球蚴病的患者均经CT检查,分析CT表现特点,并对照手术病理结果.结果23例均为单发病灶,右肺15例,左肺8例,下肺多于上肺;CT检查大致分为2型：单纯肿块型7例,表现大小不等、外形欠规则的实性肿块,边缘毛糙,可见浅分叶,周围肺野可见少许纤维影,6例病灶内见弧形或斑点状钙化;肿块呈囊腔型16例,表现为肺内含囊腔肿块,囊腔大小不等,可呈偏心改变;病灶呈球形或不规则型,边缘毛糙,欠光整,周围肺野见棘状或片絮状改变,4例因囊膜剥离形成＂水蛇征＂或＂飘带征＂;囊肿钙化7例,表现为囊壁呈弧线形钙化,或伴有内容物的斑点状钙化.结论CT检查能准确显示肺棘球蚴病的部位和形态特征,对该病的诊断和治疗有重要意义.     

肺错构瘤的影像学诊断

目的 探讨肺错构瘤的X线、CT及正电子发射体层成像(PET-CT)表现及其诊断价值.资料与方法 回顾性分析20例经手术病理证实的肺错构瘤的影像学资料.结果 左肺8例,右肺12例.除1例出现浅分叶外,其余病灶均表现为边界清楚的类圆形结节影,均为单发病灶.7例胸片病灶表现为边界清楚的结节影,1例见环状钙化;13例CT均表现为边界清楚的结节影,8例可见周围血管受压推移,10例薄层扫描可见病灶内脂肪,增强扫描病变呈轻度强化;2例在PET-CT上未见显影剂浓聚.结论 胸片有助于错构瘤的检出,薄层CT平扫及增强对其诊断价值较高.     

肺硬化性血管瘤的影像学表现及误诊分析

目的探讨肺硬化性血管瘤的X线、CT表现及误诊原因,提高本病的诊断准确率。方法回顾性分析16例资料完整且经病理证实的肺硬化性血管瘤X线、CT表现。结果左肺8例,右肺8例;均呈圆形或类圆形,边缘光整12例,浅分叶3例,1例边缘不规整;密度均匀12例,CT值约为42HU,点状钙化2例,空气半月征1例,囊变坏死1例,血管贴边征2例;增强10例,明显均匀强化9例,不均匀强化1例。术前误诊8例,误诊为周围型肺癌(n=4),转移瘤(n=2),错构瘤(n=1),曲霉菌球(n=1)。结论 PSH特征性表现为肺内孤立性,圆形或类圆形肿块,边缘光整,明显强化,偶见点状钙化及空气半月征,而对其影像特征及鉴别诊断认识不足是误诊的主要原因。     

非典型肺转移瘤的X线和CT表现及其鉴别

目的 :探讨非典型肺转移瘤的X线和CT表现及其鉴别。材料和方法 :回顾性分析 14例有原发病灶并经手术病理及组织学证实的非典型肺转移瘤的X线和CT表现。结果 :非典型肺转移瘤的X线和CT表现有多发性钙化 2例、单发转移 4例、多发性空洞 3例、肺炎型 1例、自发性气胸 1例和肺泡壁蔓延 1例。结论 :熟悉非典型肺转移瘤的X线和CT表现有助于原发恶性肿瘤及非恶性病变诊断和鉴别诊断     

肺肉瘤样癌的CT 诊断及误诊分析

目的：探讨肺肉瘤样癌的C T表现特征。方法回顾性分析14例经病理证实肺肉瘤样癌C T 资料,并与病理结果进行对照分析。结果14例中12例为单发,2例为多发,中央型4例,周围型10例,病变平扫呈软组织密度,12例呈不均匀强化,内部有囊变坏死区,10例患侧胸膜肥厚,免疫组织化学14例均表达CK （＋）,Vim （＋）。结论肺肉瘤样癌CT表现具有一定特征性,CT检查有助于肺肉瘤样癌的定位定性及明确肿瘤与周围组织结构的关系,为手术方案提供可靠的影像学依据。免疫组织化学CK和Vim对肺肉瘤样癌的诊断有决定性作用。     

脾脏错构瘤的CT诊断

目的：探讨脾脏错构瘤（SH）的CT诊断价值。方法：回顾性分析9例经病理证实的SH的CT平扫及三期动态增强表现。结果：本组9例中,8例单发病灶,1例多发病灶。单发病灶CT表现：3例平扫呈等密度,4例呈稍低密度（其中2例边缘伴钙化）,1例呈高密度,病灶呈爆米花样钙化。多期增强扫描表现为动脉期弥漫性不均匀轻度强化或周围斑片状强化（6例）,动脉期明显强化（1例）,延迟后上述病灶均接近或稍高于脾实质密度。1例爆米花样钙化各期均未见强化;本组1例多发病灶者共发现8个病灶,最大径1.2～9.5cm不等,CT显示脾上极1个病灶以囊性为主,边缘弧形钙化。其余病灶为实性结节或肿块,以等低密度为主,边界欠清,增强后呈弥漫性、渐进性强化。结论：SH的CT表现有一定特征,当CT平扫显示脾内等或稍低密度实性肿块,伴或不伴钙化,多期增强扫描动脉期病灶呈弥漫性不均匀轻度强化或周围斑片状强化,随时间延迟呈渐进性强化,延迟期接近或稍高于脾实质密度时有助于SH的诊断。     

Imaging of pulmonary hydatid cyst in children

PURPOSE: We present the various imaging features of pediatric pulmonary hydatidosis based upon a series of 232 cases. The importance of chest radiographs and thoraco-abdominal ultrasound is emphasized. PATIENTS AND METHODS: A retrospective study of 232 children with pulmonary hydatidosis is presented. The 232 cases (130 boys and 102 girls, age range: 18 months to 14 years) were studied between January 1982 and December 2001. Chest radiographs were available in all cases, chest ultrasound in 156 cases and abdominal ultrasound in 212 cases. CT was only performed in 40 cases. Surgery was performed for all patients. Diagnosis was confirmed with serology tests and/or pathological study of resected cysts. RESULT: The total number of pulmonary cysts detected on chest radiographs was 344. The right lung was more frequently affected than the left (208 lesions). A simple cyst was the most commonly observed lesion (220 cysts). Complicated forms were noted in 118 cases. 180 cysts were observed at ultrasound. A simple cyst presenting as an anechoic mass was noted in 140 cases. In 38 cases, the lesion was heterogeneous. In two lesions endocystic germinal membranes were detected. CT visualized 50 lesions. Thirty three lesions were complicated with endocystic floating or collapsed membranes. Bronchiectasis was observed in seven cases. CONCLUSION: Chest radiographs and thoraco-abdominal ultrasound are very useful for the diagnosis of pulmonary hydatidosis and evaluation of lesion extension. CT is useful for diagnosis of atypical or complicated lesions and to detect bronchiectasis.     

肺错构瘤的CT诊断及误诊分析(附12例报告)

目的:报告12例肺错构瘤CT特征,鉴别诊断及误诊原因。方法:回顾性分析12例经手术病理证实的错构瘤CT所见。结果:术前诊断正确者5例,误诊7例,分别误诊为:肺癌(周围型)、肺包虫、肺结核及包囊性积液。结论:瘤体内钙化并不是本病的特征性表现,重视肿瘤的形态特点,注意显示病灶内脂肪结构是减少误诊提高定性诊断准确性的关键     

白血病髓外浸润的CT、MRI表现

目的:对比分析白血病髓外浸润的CT、MRI表现,探讨CT、MRI对本病的诊断价值。方法:回顾性分析我院2011年3月至2013年10月16例经病理确诊白血病髓外浸润患者的临床和影像资料,探讨CT、MRI表现特点。结果:16例中,脑内及眼眶浸润4例,脑内病变累及颞叶、额叶、顶叶;单纯肺部浸润2例,累及上叶、下叶;肝脾同时浸润6例,均为肝、脾内多灶性病变;肺肝同时浸润2例;骶椎管内外受累2例。肺部病变为多样性,肝脏病变为弥漫性结节性,骶椎管内外受累病变为骨质破坏并软组织肿块。结论:CT、MRI可充分显示白血病髓外浸润所累及器官,但缺乏特征性,诊断仍需结合临床表现、病史、组织学、免疫生化检查等。     

Mesenchymal hamartoma of the chest wall: radiologic manifestations with emphasis on cross-sectional imaging and histopathologic comparison.

PURPOSE: To describe the imaging features of chest wall mesenchymal hamartoma with emphasis on cross-sectional imaging and comparison with histopathologic results. MATERIALS AND METHODS: For 14 mesenchymal hamartomas of the chest wall in 12 children, radiologic studies (computed tomographic [CT] scans [n = 14], radiographs [n = 11], magnetic resonance [MR] images [n = 9], and bone scintigraphic images [n = 1]) were reviewed by four radiologists with consensus agreement. Clinical history was reviewed for patient demographics and symptoms at presentation. Radiologic studies were evaluated for lesion location, size, number of affected ribs, cortical irregularity or erosion, presence and type of matrix mineralization, lung hyperaeration adjacent to the lesion, degree and homogeneity of radionuclide uptake, and intrinsic characteristics on CT and MR images. RESULTS: Patients included seven male and five female children. Nine patients (75%) were younger than 1 year. Five patients had a chest wall mass; in the remaining seven, the lesion was discovered incidentally. All 14 lesions arose from ribs, 11 were located posteriorly, and 11 affected multiple contiguous ribs. Two patients had multifocal disease, each with two discrete lesions. Radiography in all cases revealed a large expansile rib lesion and an associated extrapleural soft-tissue mass, suggesting an aggressive process. Mineralization was seen in seven (64%) lesions at radiography and in 14 (100%) lesions at CT. Hemorrhagic cavities (secondary aneurysmal bone cyst [ABC] regions) were common, seen in nine (64%) lesions at CT and in four (80%) of five lesions imaged with T2-weighted MR imaging. CONCLUSION: Mesenchymal hamartoma of the chest wall may be recognized by its characteristic occurrence in infancy and cross-sectional imaging features of mineralization and hemorrhagic cystic (secondary ABC) components.