CAJ | 학술논문

目的：探讨肺硬化性血管瘤(pulmonary sclerosing hemangioma, PSH)的MSCT表现，并对误诊病例进行分析，提高对本病的诊断水平。方法回顾性分析本院2010-2014年经手术或活检病理证实的PSH患者11例，男性2例，女性9例；7例行CT增强扫描，4例仅行平扫，其中5例病灶行多平面重建技术(multi-planar reconstruction，MPR)。结果11例PSH均为单发，其中10例表现为圆形或椭圆形，1例形态不规则。5例密度均匀，6例密度不均，其中3例合并囊变，2例可见斑点状钙化。4例可见浅分叶，余病灶边界较光滑。增强扫描病灶实性部分均呈较明显强化，并持续强化,其中2例病灶延迟强化。1例病灶表现为磨玻璃密度结节，5例显示“贴边血管征”，2例显示“尾征”。术前共误诊6例，其中2例误诊为周围型肺癌；1例误诊为细支气管肺泡癌；1例误诊为错构瘤；1例误诊为转移瘤；1例误诊为结核球。结论 PSH多见于中老年女性，常表现为肺内孤立性结节或肿块，MSCT表现有一定的特点，明显强化、“血管贴边征”、“尾征”等影像特点有助于其诊断，从而减少术前误诊；MPR技术能帮助病灶空间定位，更好地显示病灶与邻近组织的关系。
목적：탐토폐경화성혈관류(pulmonary sclerosing hemangioma, PSH)적MSCT표현，병대오진병례진행분석，제고대본병적진단수평。방법회고성분석본원2010-2014년경수술혹활검병리증실적PSH환자11례，남성2례，녀성9례；7례행CT증강소묘，4례부행평소，기중5례병조행다평면중건기술(multi-planar reconstruction，MPR)。결과11례PSH균위단발，기중10례표현위원형혹타원형，1례형태불규칙。5례밀도균균，6례밀도불균，기중3례합병낭변，2례가견반점상개화。4례가견천분협，여병조변계교광활。증강소묘병조실성부분균정교명현강화，병지속강화,기중2례병조연지강화。1례병조표현위마파리밀도결절，5례현시“첩변혈관정”，2례현시“미정”。술전공오진6례，기중2례오진위주위형폐암；1례오진위세지기관폐포암；1례오진위착구류；1례오진위전이류；1례오진위결핵구。결론 PSH다견우중노년녀성，상표현위폐내고립성결절혹종괴，MSCT표현유일정적특점，명현강화、“혈관첩변정”、“미정”등영상특점유조우기진단，종이감소술전오진；MPR기술능방조병조공간정위，경호지현시병조여린근조직적관계。
Objective To investigate the MSCT features of pulmonary sclerosing hemangioma (PSH) and analyzed the misdiagnosed cases,in order to improve the diagnostic accuracy.Methods MSCT features of 11 patient(9 females and 2 males)with PSH which confirmed by pathology from 2010 to 2014 were analyzed retrospectively,among which 7 cases underwent plain and enhanced CT scan,4 cases underwent plain CT scan only,and 5 cases had multiple planar reconstruction.ResultsA total of 11 cases were solitary,10 were round or oval in shape,and 1 case was irregular nodules.Five cases showed homogeneous density and the other 6 cases showed inhomogeneous,in which,3 cases with cystic degeneration,2 cases showed spotty calcification.All cases had smooth edge except 4 cases with light lobulated edge.All the cases had obvious enhancement,and 2 cases had delayed enhancement.One case showed ground glass density,"welt vessel signs" in 5 cases and "tail signs" in 2 cases.Six cases were preoperative misdiagnosed.Two of them were misdiagnosed as peripheral lung cancer,one was diagnosed as bronchioalveolar carcinoma, one hamartoma,one metastasis and one tuberculoma. Conclusions The PSH is common in middle-aged and senior women and had some special MSCT features.Obvious enhancement,"welt vessel signs" and "tail signs" were very helpful for the diagnoses. The MPR can help the spatial orientation and display the relationship between the lesions and adjacent tissues.