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目的肺硬化性血管瘤(SHL)是一种少见的肺部良性肿瘤,临床表现和影像学特征较少,术前诊断准确率较低。本文分析SHL的CT表现结合病理特征,并综合文献复习,以提高对本病的认识。方法检查方法:采用美国GE公司Hispeed NX/i型CT机,6例均行CT平扫加增强,增强造影剂采用碘帕醇。结果6例病人,男1例,51岁,女5例,平均年龄49.6岁,均为单发病灶,靠近肺的边缘部,形状呈类圆形,无明显分叶,边缘光滑。平扫密度较均匀,2例有少许钙化,CT增强3例明显强化,3例强化不均。肺门及纵隔淋巴结无肿大。结论根据本组资料的回顾性分析和复习文献,我们认为以下影像特征可供参考:多数表现为肺内类圆形孤立性肿块(SPN),肿瘤轮廓清晰,边缘光滑、锐利,可有浅分叶和小钙化,肿块多数位于肺边缘近胸膜下。CT平扫密度多较均匀,偶见钙化和空气半月征,空气新月征是SHL较为特征的表现,但此特征不常见。CT薄层扫描见瘤体内有界限清晰的高密度与低密度之分,而且增强扫描高密度区强化明显,低密度区基本不增强,此表现较为特征。另外,肿块强化明显而且出现混杂密度,也考虑到SHL的可能。诊断不清时经皮肺穿刺可酌情使用。
Objective Pulmonary sclerosing hemangioma (SHL) is a rare benign tumor of the lung with few clinical manifestations and imaging features and low accuracy of preoperative diagnosis. This article analyzes the CT manifestations of SHL combined with pathological features, and comprehensive literature review to improve the understanding of the disease. Methods of examination: US His company Hispeed NX / i-type CT machine, 6 cases underwent CT scan plus enhanced contrast enhancement agent with iopamidol. Results Six patients, 1 males, 51 females and 5 females, with an average age of 49.6 years were single lesions, close to the edge of the lungs. The shape was round, with no obvious lobes and smooth edges. The average density of plaque was more uniform, with a little calcification in 2 cases, significant enhancement in 3 cases with CT enhancement and unequal enhancement in 3 cases. Hilar and mediastinal lymph nodes without swelling. Conclusions Based on the retrospective analysis and review of the literature in this group, we consider the following imaging features for reference: most are sporadic isolated masses (SPN) in the lungs with clear tumor outline, smooth edges, sharp edges and shallow Leaves and small calcification, the majority of lumps located in the lungs near the subpleural. CT scan density more evenly, occasionally calcified and air half moon sign, air crescent sign SHL is more characteristic performance, but this feature is not common. CT thin-layer scan showed a clear high-density and low-density of the tumor points, and enhanced scanning high-density area significantly enhanced, low-density area basically does not enhance, the performance is more characteristic. In addition, the mass enhancement obvious and mixed density, but also take into account the possibility of SHL. Diagnostic percutaneous puncture may be appropriate to use.