肺硬化性血管瘤的CT表现及病理学分析

目的：回顾性分析肺硬化性血管瘤（PSH）的CT及病理学特点,提高对PSH的影像诊断水平。方法：收集2008年4月至2012年7月由病理证实的PSH共22例,女21例,男1例,年龄15-72岁,平均48岁。所有病例均行CT平扫,其中17例行CT增强扫描。影像学征象由两名资深胸部影像诊断医师共同讨论完成。结果：CT显示病变直径平均（3.0±1.3）cm,形状呈类球形15例（68%）,不规则形7例（32%）,所有病例均显示边缘光滑（100%）;平扫2例（9%）病灶内有斑点状钙化,1例呈混合磨玻璃影,其余19（86%）密度均匀,CT值为（35±7）HU;17例增强扫描中,10例显示均匀强化,7例呈明显不均匀或延迟强化,平均强化值约为（80±5）HU。结论：总结分析以下指标有助于对PSH的诊断：（1）女性患者,边缘光滑的类球形或卵圆形肺结节,周围无毛刺及卫星灶;（2）CT平扫密度较均匀,有时病灶呈磨玻璃影和内可见点状钙化,（3）增强扫描根据病灶大小可呈均匀强化或明显不均匀强化。

The CT Imaging and Pathology Analysis of Pulmonary Sclerosing Hemangioma

Objective： To retrospectively evaluate the diagnosis value of imaging with pathology for PSH and improve the diagnosis ability of the disease.Methods： 22 cases of PSH proved by operation and histopathology from April 2008 to July 2012 were collected,including 21 female and 1 male,and their age were from 15 year-old to 72 year-old,with an average of 48 years.All the cases underwent CT scan,17 cases among which received enhanced CT scan.The imaging findings were summarized by two radiologists.Results： The lesion average size was 3.1±1.3 cm.15 cases（68 %） were round in shape,and 7 cases（32 %） were irregular,as well as 5 cases were lobulated in these irregular.All cases（100 %）were smooth.On precontrast CT,the average CT value of 21 cases was 35±7 HU,while punctiform calcification could be seen in 2 cases and mix ground-glass opacity could be seen in 1 case.The average enhancement was 80±5 HU.10 cases showed homogeneous and 7 cases showed intense and heterogeneous enhancement.Conclusion： PSH should be considered with the following features：（1） female patients well-defined round or oval shaped lesion;（2） a homogeneous soft-tissue mass on unenhanced CT： ground-glass opacity in the tumor and/or calcification can occasionally be found;（3） homogeneous or heterogeneous enhancement after contrast administration.