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。

Imaging diagnosis of pulmonary sclerosing hemangioma and misdiagnosis analysis

Objective To discuss the X-ray and CT features of pulmonary sclerosing hemangioma and the causes of misdiagnosis,so as to improve the diognosis.Methods CT and X-ray characteristic of 16 patietnts with pulmonary sclerosing hemangioma proved by pathology were retrospectively analyzed.Results Among 16 cases of pulmonary sclerosing hemangioma,8 lesions located in right lung,8 lesions in left lung;all appeared to be round or class round,12 lesions were smooth in the edge,3 lesions were lobulated in morphology,1 lesion was irreqular;12 lesions were homogeneous density with an average CT value of 42 HU,2 lesions were Pointlike calcification,1 lesion showed characteristic air trapping zone,1 lesion was cystic necrosis,2 lesions were welt vessel signs;Nine lesions were enhanced homogeneously and another 1 lesion was enhanced heterogeneously among ten lesions.Imaging misdiagnosis was made in 8 cases,including peripheral lung cancer(n=4),metastases(n=2),hamartoma(n=1) and aspergillus ball(n=1).Conclusion Pulmonary sclerosing hemangioma characteristically were isolated in the lungs,which appeared to be round or class round,smooth in edge,obviously enhanced,occasional pointlike calcification and air trapping zone.The main misdiagnosed reasons were inadequate understanding with image characteristics and the differential diagnosis.