肺内孤立结节周围病灶的HRCT特征

目的 观察肺内常见孤立结节周围病灶的HRCT特征.方法 回顾分析经临床及病理证实的结核球、球形肺炎、不典型支气管肺囊肿、周围型肺癌、错构瘤及硬化性血管瘤的CT资料,记录分析结节周围病灶的HRCT特征.结果 结核球周围病灶以结节为主(66.67%),树芽征占12.64%,后者在其他性质结节中很少出现.球形肺炎周围病灶主要表现为絮状影(96.92%).周围型肺癌周围主要表现为胸膜凹陷征(76.04%)、血管集束征(14.58%).不典型支气管肺囊肿周围以絮状影(64.00%)、斑片影(24.00%)及局灶肺气肿(64.00%)为主.1例硬化性血管瘤周围出现絮状影.本组错构瘤均未出现周围病灶.结论 分析肺内孤立结节周围病灶的HRCT特征有助于鉴别诊断肺内肺结核球、球形肺炎、周围型肺癌及不典型支气管肺囊肿等常见孤立结节病变.

High-resolution CT features of satellite lesions around solitary pulmonary nodules

Objective To observe the high-resolution CT (HRCT) features of satellite lesions around solitary pulmonary nodules. Methods CT images of tuberculoma, spherical pneumonia, atypical bronchopulmonary cyst, peripheral lung cancer, hamartoma and sclerosing hemangioma confirmed with clinically and pathologically were retrospectively analyzed. HRCT findings of lesions around the nodules were recorded and analyzed. Results The nodular lesions were mainly found around tuberculoma (66.67%), while tree-in-bud sign which was seldom in other solitary pulmonary nodules occupied 12.64%. The flocculent shadow was the major CT feature of satellite lesions around spherical pneumonia (96.92%). Pulmonary nodules associated with pleural indentation occupied 76.04% in peripheral lung cancer, and the vessel convergence sign occupied 14.58%. Atypical bronchopulmonary cyst was frequently surrounded with flocculent shadow (64.00%), plaques (24.00%) and focal emphysema (64.00%). The flocculent shadow was found in only 1 patient with sclerosing hemangioma. There was no satellite in all hamartoma. Conclusion Analyzing of the morphological features of satellite lesions around solitary pulmonary nodules with HRCT is helpful to the differential diagnosis among pulmonary tuberculoma, spherical pneumonia, peripheral lung cancer and atypical bronchopulmonary cyst.