孤立性肺结节的鉴别诊断：肺错构瘤的CT征象

目的探讨肺错构瘤的CT表现和诊断价值。方法对53例经手术病理或2年以上随访证实的肺错构瘤患者的临床资料和CT图像进行回顾性分析。患者年龄17～76岁，平均43岁，女性36例，男性17例。健康体检发现48例，因呼吸系统症状就诊发现5例。分别使用单层螺旋CT、4层螺旋CT和16层螺旋CT扫描，层厚和层距2mm-10mm之间，其中平扫7例，平扫＋增强46例。观测SPN形态和大小用肺窗（WW-1000--1500HU）．测定病灶密度和强化程度用纵隔窗（WC40-50HU）。手术、经皮肺穿刺或胸腔镜活检病理证实17例．随访证实36例。结果均为单发病灶，直径小于20mm者44例，大于20mm者9例；边缘光滑者11例，边缘分叶和（或）长毛刺者42例；密度均匀者15例，不均匀者38例，测得钙化或（和）脂肪密度者15例；注射对比剂后轻度强化者2例，无强化者51例。结论肺错构瘤以周围型孤立性结节居多．直径多在2cm以下，可见边缘分叶或（和）长毛刺，平扫密度高或呈岛状高密度，常见散在性钙化．典型者内见脂肪密度或（和）爆米花样钙化，增强扫描不强化。

The differentiated diagnosis of solitary pulmonary nodules: CT features of the hamartoma

Objective Purpose To probe the CT features by spiral computed tomography. Methods Fifty-three cases of pulmonary hamartoma confirmed by operative pathology and followlng-up were retrospectively reviewed. In the group, patient＇s age was from 17-76 years old （average in 43 yrs）, and the gender was in male （n=17 eases） and female （n=36 eases）. Forty-six patients performed the plain and enhanced CT examinations respectively, but seven cases only with the plain CT scanning. The shape and density of the pulmonary hamartoma were observed and measured on CT images. Results The longer dimension of the tumors on CT was from 7 mm to 30 mm with an average 16mm. The shapes and borders were respectively showed as lobulation（in 11 cases） and spiculation（in 44 cases）. The measured densities values of tumors in the plain CT were in higher to the soft tissue （11=45 cases）, in calcification （n=5 cases ） and in fat（n =3 cases）respectively. There was mildly enhanced patients （11=2 cases ） and no enhanced ones （n=51 cases ） after contrast material administration. Conclusion Because of the special CT features of the pulmonary hamartoma, so it can plays an important role for the preoperative diagnosis.