周围型肺错构瘤的HRCT表现与病理对照研究

目的：探讨周围型肺错构瘤的ＨＲＣＴ特征及其病理基础,以期提高诊断准确率。材料和方法：回顾性对照研究２５例经手术和病理证实的周围型肺错构瘤的ＨＲＣＴ及其病理表现。结果：所有肺错构瘤均单发,右肺１４例,左肺１１例;２４例病灶贴近胸膜（９６％）,距胸膜平均距离为０．６４ｃｍ。余１例距胸壁为４．４ｃｍ。病灶呈圆形或椭圆形,边缘清晰镜利,１２例见分叶征（４８％）,７例见一条血管影进入病灶（２８％）。ＨＲＣＴ显示４例含脂肪成分（１６％）,９例有钙化（３６％）（其中４例为爆玉米花样钙化）。术前ＨＲＣＴ诊断正确者１６例（６４％）。病理上所有病灶均有完整的纤维包膜,２３例（９２％）见软骨、腺体、平滑肌和纤维结缔组织等结构,１１例（４４％）见不同程度的脂肪发,８例（３２％）见不同程度的钙化。结论：周围型肺错构瘤的ＨＲＣＴ表现有一定

Correlative Study of HRCT and Pathological Findings of Peripheral Pulmonary Hamartoma

Purpose: For improvement of diagnostic accuracy, HRCT and pathological characteristics of peripheral pulmonary hamartoma (PPH) were evaluated. Materials and Methods: A correlative study of HRCT and pathologic findings of 25 cases with PPH was carried out retropsectively. Results: All 25 cases had a solitary PPH. Fourteen and 11 of 25 lesions were located in right and left lung respectively. Twenty- four PPHs(96% ) were found just under the pleura, and the average distance between the pleura and PPH was 0. 64cm. Another one (4% ) was located 4. 4cm away from the pleura. All lesions were round or oval in shape. Margins of lesions were clear - cut in all cases, and in 12 of them (48% ) were lobular. A vessel entering into the mass was seen in 7cases (28%). Fat was shown in 4 cases (16%). Nine hamartomas (36% ) had calcifications, and 4 of them (16% ) had a "popcorn" sign. Sixteen cases (64% ) were correctly diagnosed with HRCT pre - operatively. Pathologically, PPH consisted of cartilage , gland, smooth muscle and fibrous connective tissue in 23 cases (92 % ), and fat and calcium were found in 11 (44% ) and 8 (32% ) cases respectively. PPH had a complete fibrous capsule around in all 25 cases. Conclusion: Certain specific CT features of PPH, including clear - cut margin, calcification and fat inside etc, are very useful for correct diagnosis of PPH.