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目的:探讨肺硬化性血管瘤(PSH)的多层螺旋CT(MSCT)表现,并对照病理结果进行分析,以提高对其认识及影像诊断水平。方法:回顾性分析39例经病理确诊的PSH患者的CT征象,3例仅行胸部CT平扫,余36例行CT平扫和增强。结果:男6例,女33例,平均年龄(46.9±14.36)岁,均为单发病灶,左肺19例,右肺20例。周围型30例,中央型9例,胸膜下32例(15例宽基底贴于胸膜),非胸膜下7例。病灶最大径5~57 mm,呈类圆形或卵圆形,边界清晰,11例边缘见浅分叶。平扫33例密度较均匀,6例欠均匀,平均CT值(34.0±13.4)HU,12例内见钙化。增强扫描多为中等至明显强化(30例),22例强化较均匀,14例强化不均匀,其中4例见低密度坏死区。动脉期平均CT值(77.0±25.6)HU,静脉期病灶呈渐进性或持续强化,平均CT值(91.0±17.1)HU。贴边血管征30例,周围磨玻璃密度影4例。结论:PSH的MSCT表现中贴边血管征、周围GGO征、显著肺动脉征、空气新月征及尾征,具有相对特征性,有助于提高术前的诊断准确性。
Objective: To investigate the multi-slice spiral CT (MSCT) manifestations of pulmonary sclerosing hemangioma (PSH) and to analyze the pathological results to improve their understanding and imaging diagnosis. Methods: CT findings of 39 pathologically confirmed PSH patients were retrospectively analyzed. Thoracic CT scan was performed in 3 cases and CT scan and enhancement were performed in 36 cases. Results: There were 6 males and 33 females, with an average age of (46.9 ± 14.36) years. All of them were single lesion. There were 19 cases of left lung and 20 cases of right lung. Peripheral in 30 cases, 9 cases of central type, 32 cases of pleura (15 cases of wide basement attached to the pleura), non-subpleural in 7 cases. The maximum diameter of lesions 5 ~ 57 mm, were round or oval-shaped, clear boundary, the edge of 11 cases see the shallow leaves. The density of 33 cases was more uniform, 6 cases were less uniform, the average CT value was (34.0 ± 13.4) HU, and calcification was seen in 12 cases. Most of the contrast-enhanced MRI were moderate to obvious enhancement (30 cases), 22 cases were more uniform and 14 cases were non-uniform. Among them, 4 cases showed low-density necrosis. The mean arterial phase CT value was (77.0 ± 25.6) HU, and the venous phase lesions were progressive or continuous enhancement. The mean CT value was (91.0 ± 17.1) HU. Borderline blood vessels sign in 30 cases, around the glass density of 4 cases. CONCLUSIONS: Peculiar vascular occlusion, peripheral GGO sign, significant pulmonary artery sign, air crescent sign and tail sign in MSCT manifestations of PSH are relatively characteristic and help to improve the accuracy of preoperative diagnosis.