肺硬化性血管瘤的DR和CT表现

目的:分析肺硬化性血管瘤的DR和CT表现,以提高其诊断水平。材料和方法:回顾性分析我院2004-03～2006-1021例经病理证实的肺硬化性血管瘤的DR和CT表现。21例均摄DR胸部正、侧位片,胸部CT平扫6例,胸部CT平扫+增强扫描15例,对增强扫描的图像进行过减薄处理并对减薄图像进行三维重建10例。结果:DR示肿瘤边缘光整,分叶不明显18例(密度均匀15例,中间可见散在点状钙化2例,不规则钙化1例),浅分叶2例,右侧胸腔积液1例。CT平扫示肿瘤呈圆形或卵圆形肿块,边界光整锐利16例(分叶不明显14例、浅分叶2例),边界不光整4例(分叶2例,分叶不明显2例),与周围分界不清1例;密度均匀15例,不均匀6例,病灶内点状钙化3例,不规则钙化1例,“空气新月征”1例,胸腔积液1例。增强扫描示病灶明显增强。结论:DR和CT平扫显示肿瘤呈圆形或卵圆形,边缘光整等良性肿瘤表现;CT增强扫描示肿瘤明显增强是肺硬化性血管瘤的CT典型表现。CT减薄处理及三维重建对其诊断提供更大帮助。

DR and CT Findings of Pulmonary Sclerosing Hemangioma

Purpose: To analyze the DR and CT findings and improve the diagnosis of pulmonary sclerosing hemangioma(PSH). Materials and Methods: The DR and CT findings of PSH confirmed by pathology in 21 cases were analyzed retrospectively at our hospital between Mar. 2004 and Oct. 2006. All cases underwent antero- posterior and lateral chest DR, 6 cases only underwent precontrast enhancement chest CT scan, 15 cases underwent pre- and post- contrast enhancement CT scans including thin slice and 3D reconstruction in 10 cases. Results: On DR, the lesions were well defined and non- lobulated in 18 cases (including homogeneous attenuation in 15 cases, two lesions with punctuate calcification, one with irregular calcification), two had slightly lobulated margins and one had the sign of pleural effusion. On pre-contrast enhanced CT images, the lesions were demonstrated as a round or oval mass with smooth margins in 16 cases (14 cases without lobulation and 2 with slight lobulation), 4 cases had ill defined margins (2 without lobulation and 2 with slight lobulation). The density of the lesions was homogeneous in 15 cases and inhomogeneous in 6 cases (including 3 lesions with punctuate calcification, 1 with irregular calcification). One had the sign of air meniscus and 1 had pleural effusion. All lesions were homogeneous enhancement on contrast enhanced CT scans. Conclusions: PSHs are round or oval mass with smooth margins and have common benign features on DR and pre-contrast enhanced CT scan. The typical features of PSHs are intensively enhancement on contrast enhanced CT scan. Thin slice and 3D reconstruction are helpful for diagnosis.