肺硬化性血管瘤的CT影像学特点

目的：分析肺硬化性血管瘤（PSH）的CT表现,提高对此病的诊断能力。方法：本组经手术及病理证实的PSH共18例,其中女16例,男2例,年龄19～60岁,平均43岁,所有病例均行CT平扫,其中16例行增强扫描。结果：18例均为孤立肿物,长径1.9～4.2cm,平均长径（2.7±1.3）cm。形状呈圆形5例（27.8%）,卵圆形9例（50%）,边缘浅分叶4例（22.2%）,边缘光滑14例（77.8%）,2例（5.6%）有空气新月征,3例（16.7%）有晕征。2例（11.1%）病灶内有散在小结节状钙化,余病变密度均匀,CT值为28～47HU,平均35HU,16例增强扫描,8例有贴边血管征,1例轻度强化,5例呈明显均匀强化,10例强化不均匀。增强后CT值为60～110HU,平均72HU,最大强化净值为80HU,平均55HU。结论：CT发现中年女性单发圆形或卵圆形肺结节,边缘光滑,可伴有空气半月征及晕影,增强呈明显强化,应考虑到PSH的诊断。

CT features of pulmonary sclerosing hemangioma

Objective：To analyze the CT morphology features of pulmonary sclerosing hemangioma （PSH） so as to improve the diagnostic level of this lesion.Methods：18 cases of PSH confirmed by operation and histopathology from August 2002 to May 2009 were collected,including 17 females and 2 males,aged 19~60 years （mean 43）.All the cases underwent plain CT scan,among them,16 cases received enhanced CT scan.Results：All the 18 cases were isolated mass,the mean long-axis diameter being （2.7±1.3）cm （range,1.9~4.2cm）.5 cases （27.8%） were round in shape,9 cases （50%） were ovoid,and 4 cases （22.2%） were lobulated.There were smooth margins in 14 cases （77.8%）,air meniscus signs in 2 cases （11.1%） and halo signs in 3 cases （16.7%）.Two cases （11.1%） contained small nodular calcification.16 cases （70%） had homogeneous density,the CT density of the mass ranging from 24~47HU with a mean value of 35HU.Of the 16 cases receiving enhanced scan （there were welt vessel signs in 8 cases）,one case showed slight enhancement,5 cases showed marked homogeneous enhancement and 10 cases showed intense and patchy heterogeneous enhancement.The CT density of the enhanced mass ranged from 60~110HU,the mean value being 72HU,and the net enhancement value was 14~80HU,the mean value being 55HU.Conclusion：PSH should be considered in the diagnosis of middle-aged females whose CT show single round or oval pulmonary nodules with smooth margin or associating with air meniscus sign or halo sign,or with strong homogeneous enhancement.