肺错构瘤的CT表现及其与其他疾病的鉴别

目的分析肺错构瘤的MSCT表现及其与其他疾病的鉴别。方法对26例行MSCT检查并经手术和病理证实的肺错构瘤进行回顾性分析。结果本组26例均为单发肺错构瘤,其中22例为周围型,位于右肺12例,位于左肺10例;4例为腔内型,其中,1例位于气管中段腔内,1例位于左主支气管内,2例位于左肺下叶支气管内。病灶呈圆形或椭圆形,边缘锐利,9例显示有浅分叶,但均无毛刺。本组22例周围型错构瘤中,3例病灶内含有脂肪密度影;9例病灶内含有钙化影,其中3例为典型的爆米花样钙化;10例病灶呈均匀软组织密度影。4例腔内型错构瘤中,3例病灶内含有脂肪成分,1例含有钙化影。本病主要需于肺炎性假瘤、小叶癌、结核瘤相鉴别。结论肺错构瘤的MSCT表现有一定特征,病灶边缘清楚,内含有脂肪和钙化有助于正确诊断。

CT findings of the pulmonary hamartoma and its differentiation from other diseases

Objective To analyze the CT findings of the pulmonary hamartoma and its differentiation from other lung diseases.Methods CT findings of 26 patients with surgically and pathologically proved pulmonary hamartoma and received MSCT examinations were analyzed retrospectively.Results The study demonstrated that there were 22 peripheral types（12 in right lungs and 10 in left lungs） and 4 central types（1 in tracheal middle segment,1 in left main bronche,and 2 in lower lobes of the left lungs） in 26 cases.On CT images,the hamartoma lesions of all patients appeared as round or oval shape with well-defined margin.Among 22 cases of peripheral type hamartomas,9 had shallow lobulations around the lesions but had no spiculation,3 had intralesional fat density shadows,9 had intralesional calcified shadows which comprised 3 typical popcorn calcifications,and 10 appeared as homogeneous soft tissue density shadows,while among 4 cases of central type hamartomas,intralesional fat components and calcified shadows were found in 3 cases and 1 cases,respectively.The pulmonary hamartoma lesions shoul be differentiated from other lung diseases such as pulmonary inflammatory pseudotumor,small lung cancer,and tuberculoma.Conclusion CT findings of pulmonary hamartoma are characterized by well-defined margin,intralesional fat and calcification,which are helpful to correctly diagnose this disease.