叶内型肺隔离症诊治分析

目的总结叶内型肺隔离症的诊断及外科治疗体会,提高对肺隔离症的认识。方法对经病理证实的23例叶内型肺隔离症的临床和影像学资料进行分析。结果 23例中,病变位于左肺下叶17例,位于右肺下叶6例。患者临床症状表现为反复咳嗽、咳痰15例,反复咯血4例,反复肺部感染3例,腰痛1例。病灶呈囊性5例,实性15例,囊实性3例。23例均为叶内型。其中20例术前经影像学检查诊断,主要诊断方法为增强CT扫描及多平面重建(MPR)、最大密度投影(MIP),可清晰显示病变的强化特点,异常供血动脉及与周围结构的关系。结论叶内型肺隔离症较易误诊,CT增强扫描及MPR、MIP能清晰的显示肺隔离症的病变特征,为首选检查方法。手术切除是本病最佳治疗方法。

Diagnosis and treatment of 23 patients with intralobar pulmonary sequestration

Objective To summarize the experience of intralobar pulmonary sequestration diagnosis and surgical treatment. Methods The clinical and imaging data of 23 patients with pathologically confirmed pulmonary sequestration were retrospectively ana- lyzed. Results In 23 cases, the lesions in the left lower lobe were 17 cases, and 6 cases in the right lower lobe. The clinical symptoms mainly included 15 cases of repeated cough and expectoration, 4 eases of hemoptysis, 3 cases of repeated lung infections, and 1 ease of lumbago. The lesions included 5 cases of cystic, 15 cases of solid, 3 cases of solid and cystic. The 23 cases were all intralobar, 20 of which were diagnosed by imaging studies. The main diagnostic methods were enhanced CT scan and multi-planar reconstruction （ MPR）, and maximum intensity projection （MIP）. Conclusion Intralobar pulmonary sequestration is easily misdiagnosed. The best inspection methods are enhanced CT scan, MPR, and MIP, which can clearly show the lesions characteristic of pulmonary sequestration, and the best treatment method is surgical resection for this disease.