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目的:回顾性分析肺硬化性血管瘤(PSH)的CT及病理学特点,提高对PSH的影像诊断水平。方法:收集2008年4月至2012年7月由病理证实的PSH共22例,女21例,男1例,年龄15-72岁,平均48岁。所有病例均行CT平扫,其中17例行CT增强扫描。影像学征象由两名资深胸部影像诊断医师共同讨论完成。结果:CT显示病变直径平均(3.0±1.3)cm,形状呈类球形15例(68%),不规则形7例(32%),所有病例均显示边缘光滑(100%);平扫2例(9%)病灶内有斑点状钙化,1例呈混合磨玻璃影,其余19(86%)密度均匀,CT值为(35±7)HU;17例增强扫描中,10例显示均匀强化,7例呈明显不均匀或延迟强化,平均强化值约为(80±5)HU。结论:总结分析以下指标有助于对PSH的诊断:(1)女性患者,边缘光滑的类球形或卵圆形肺结节,周围无毛刺及卫星灶;(2)CT平扫密度较均匀,有时病灶呈磨玻璃影和内可见点状钙化,(3)增强扫描根据病灶大小可呈均匀强化或明显不均匀强化。
Objective: To retrospectively analyze the CT and pathological features of pulmonary sclerosing hemangioma (PSH) and to improve the imaging diagnosis of PSH. Methods: From April 2008 to July 2012, 22 cases of pathologically confirmed PSH were collected. There were 21 females and 1 males, aged 15-72 years (average 48 years). CT scan in all cases, of which 17 cases of enhanced CT scan. Imaging signs by the two senior chest diagnostic imaging doctor to discuss the completion. Results: CT showed that the diameter of lesions was (3.0 ± 1.3) cm in average, 15 cases (68%) were spheroidoid and 7 cases (32%) irregular. All cases showed smooth edges (100% (9%) had spotted calcification in the lesion, one was mixed with ground glass, and the remaining 19 (86%) had uniform density and CT value of (35 ± 7) HU. Of the 17 enhanced scans, 10 showed homogeneous enhancement, 7 cases showed obvious uneven or delayed enhancement, the average enhancement value of about (80 ± 5) HU. Conclusion: The following indicators are helpful for the diagnosis of PSH: (1) Female patients with spheroidal or oval pulmonary nodules with smooth edges without burr and satellite lesions; (2) CT scanning density is more uniform, Sometimes the lesions showed ground glass and dot-like calcification within visible (3) enhanced scan according to the lesion size can be uniformly enhanced or significantly uneven enhancement.