硬化性肺泡细胞瘤 MSCT 征象与病理的相关性分析

目的：回顾性分析硬化性肺泡细胞瘤(PSP)的 MSCT 征象,并结合病理分析,以提高对 PSP 影像表现的认识。方法收集2006—2015年经手术病理证实的 PSP 38例,所有病例均行 MSCT 平扫加增强扫描,结合临床病理回顾性分析其影像学征象。结果38例均为单发类圆形结节、团块影；19例<3 cm,9例>5 cm,10例3~5 cm 之间；6例可见囊变,13例可见钙化；8例平扫密度表现为地图样分布；19例均匀强化；19例不均匀地图样强化,其中3例为边缘明显强化；35例并呈渐进性强化；10例动脉期可见细条样血管影；贴边血管征26例；出现晕征8例,空气新月征3例,2种征象同时出现1例；出现肺动脉为主征10例；出现尾征9例。结论PSP 具有良性肿瘤的一般特点,钙化、密度分布、增强形式、伴随征象有一定特征性,结合病理分析其 MSCT 征象,可提高影像诊断的符合率。

Correlative analysis on CT features and pathology of pulmonary sclerosing pneumocytoma

Objective To analyze the MSCT features of pulmonary sclerosing pneumocytoma (PSP)combined with pathologic findings,to improve understanding of imaging features of PSP.Methods The clinical features of 38 PSP patients confirmed by pathology between 2006 and 2015 were reviewed.All patients underwent MSCT plain and enhanced scan.The imaging findings were studied retrospectively combined with clinical pathology.Results 38 lesions were solitary roundlike nodules and masses.Among which 1 9 lesions were less than 3 cm, 9 lesions were more than 5 cm and 10 lesions were between 3 cm and 5 cm.6 lesions had cystic degeneration,13 lesions had calcification;8 lesions with heterogeneous density showed maplike distribution on unenhanced scans;1 9 lesions were homogeneous enhancement;1 9 lesions maplike heterogeneous enhancement,and 3 of 1 9 had significant peripheral enhancement;35 lesions were progressive enhancement. There were strip-shape vessels in 10 lesions in arterial phase,welt vessel sign in 26 lesions;halo sign in 8 lesions,air-meniscus sign in 3 lesions,pulmonary artery sign in 10 lesions,and tail sign in 9 lesions.There was halo sign with air-meniscus sign in 1 lesion.Conclusion PSP has the general characteristics of benign tumors,and there have certain characteristics in calcification,density distribution,enhancement form and adjoint features.A comprehensive analysis of all the MSCT features combined with clinical pathology can help to improve the accuracy of diagnoses in PSP.