肺错构瘤的影像学诊断

目的:进一步分析肺错构瘤的平片和CT影像表现,提高该病的正确诊断率。材料与方法:回顾性分析我院1973年3月～2002年3月经手术病理证实的35例肺错构瘤,其中行X线平片检查11例(包括正侧位及断层摄影),CT及HRCT24例。结果:所有肺错构瘤均单发。平片及断层摄影表现(11例):位于双肺外带者8例(73%);显示钙化2例(18%);脂肪成分未见显示。CT及HRCT(24例):18例(75%)病灶贴近胸膜,距胸膜平均距离为0.53cm;形态上多呈圆形或椭圆形;边缘均清楚,分叶10例(42%);脂肪成分和钙化的显示分别为5例(21%)和11例(46%)(其中3例为典型的爆米花样钙化);4例(17%)病灶边缘有一条血管影进入病灶内;术前诊断正确者17例(71%)。结论:典型的周围型肺错构瘤征象为爆米花样钙化和脂肪影,易于诊断。CT检查尤其是HRCT有助于非典型者与其他肺内孤立型结节的鉴别诊断。

Imaging diagnosis of pulmo nary hamartoma

Objective:To make a further understanding of find in gs of pulmonary hamartoma (PH)to improve diagnostic accuracy.Materials and M ethods:Thirty-five pulmonary hamartomas proved histopathologically were analyz ed retrospectively to examine their features.Results:All35cases had a solita ry PH.Chest radiograph plus tomography(11cases):two hamar-tomas(18% )had calcifications;fat was shown none of them.CT and HRCT(24cases):ei ghteen PH(75%)were found just un-der the pleura,and the average distance between the pleura and PH was0.53cm;all lesions were round or oval in shap e;margins of lesions were clear-cut in all cases,and in10of them (42 %)were lobular;fat and calcifications were shown respec-tively in5(21% )and11(46%)of them,and3of them had a"popcorn"sign;a vessel enteri ng into the mass was seen in4cases(17%);seventeen cases(71%)were cor rectly diagnosed preoperatively.Conclu sion:Typical pulmonary hamartomas have pop-corn calcification and intranodular fat.CT,especially HRCT,can help diff erentiate atypical hamartomas from other solid pul -monary nodules.