14例肺错构瘤CT误诊分析

目的 分析14例误诊的肺错构瘤的CT表现，提高其诊断正确率。方法 回顾性分析经病理证实的14例CT误诊的肺错构瘤CT表现，观察内容：病灶的部位、大小、形态、密度、强化、支气管、纵隔及其余肺组织情况。结果 中央型6例：其中5例误诊为中央型肺癌，1例诊断为良性病变；病灶大小6~12mm，平均8 mm；均为类圆形，边缘光滑；其中内有钙化5例，测到脂肪成分5例；支气管壁未见增厚、截断；纵隔未见淋巴结肿大；4例周围肺组织见不同程度的阻塞性肺炎、肺不张。周围型8例：其中5例误诊为周围性肺癌，2例误诊为转移瘤，1例诊断为良性病变；病灶大小28～62mm，平均35mm ；7例边缘光滑，1例边缘毛糙，均未见毛刺征；浅分叶2例，深分叶1例；内见钙化3例，均未测到脂肪成分；CT增强扫描7例强化值小于20HU，1例大于20HU。结论 中央型错构瘤CT表现有一定特征，周围型错构瘤具有良性肿瘤表现，认真分析，可减少其误诊率。

Misdiagnose analysis of CT to 14 pulmonary hamartomas

【Abstract】　Objective : Improve the value of CT in diagnoses and differentiation of pulmonary hamartomas by analysing the CT representation of 14 atypical pulmonary hamartomas. Methods : The 14 cases were studied by CT and analyzed retrospectively , all the cases were proved pathologically by biopsy or surgery. Results : There are 6 central type of interlob or intersegment bronchial nodule with obstructive pneumonia or atelectasis, and 8 peripheral type were round or oval nodule or mass , the diameter of these foci is about 4 to 62mm, averaged 21mm .Most of the lesions with smooth and regular edge (13 cases ) ,only l lesion with coarse edge. 2 lesions with slight lobulation and 1 lesions with deep lobulation , but all of the lesions have no spicule sign .7 lesions with calcification .5 lesions with fat . 13 cases enhancement value is less than 20HU, while 1 case is more than 20HU. 1 case merged peripheral lung cancer, and 1 case merged esophageal cancer. Conclusion : The atypical pulmonary. hamartomas is misdiagnosis easily, so it need to analyse the CT character seriously, especially the edge , inner structure, the enhanced character of the lesion and so on ,to improve the accuracy rate .