肺错构瘤的动态CT表现及其相关病理研究.docVIP

肺错构瘤的动态CT表现及其相关病理研究 　　作者：王锐　周祝谦 　　作者单位： 250014 山东济南，山东省千佛山医院影像科 　　【摘要】 目的 探讨肺错构瘤的CT表现及其相关的病理基础，以提高其CT诊断水平。方法 回顾性分析经手术病理证实的35例肺错构瘤的CT平扫和动态增强扫描特点及其病理表现。结果 CT上所有结节边缘光滑，有毛刺征3例。发现为均匀的软组织密度者12例，占34.29%;结节内含有脂肪密度(无钙化)者11例，占31.43%;既有脂肪又有钙化者9例，占25.71%;只有钙化者3例，占8.57%。增强扫描强化值20HU 26例，占74.29%;强化形态呈间隔状强化17例，占48.57%。病理上，所有错构瘤都有完整的纤维包膜，21例有不同程度的脂肪，占60.00%;12例可见到钙化，占34.29%。在光镜下结节内主要成分为软骨、平滑肌组织、支气管腺体、脂肪及纤维结缔组织等，血管含量少，位于软骨核之间的纤维组织内。间隔状强化与错构瘤的血管分布有关。结论 肺错构瘤的CT表现有一定的特征性，边缘光滑、结节内含有脂肪和钙化有助于诊断，动态CT增强扫描有助于其与周围型肺癌的鉴别诊断。 　　【关键词】 肺错构瘤;体层摄影;X线计算机;病理 　　The study of CT appearances of pulmonary hamartoma and relative pathology 　　WANG Rui,ZHOU Zhu-qian. 　　Qianfoshan Hospital,Jinan 250014,China 　　【Abstract】 Objective To research the appearances of CT and pathology in pulmonary hamartoma so as to improve the CT diagnostic accuracy.Methods The CT and pathological findings of 35 cases of pulmonary hamartoma were analyzed.Dynamic contrast enhancement CT scanning were performed and all cases were confirmed by surgical operation and pathology.Results All hamartomas had smooth edge on CT.Finding the average smooth density and focal fat without calcification inside were present in 12 and 11 of 35 cases，focal fat and calcification inside in 9 of 35 cases (25.71%)，calcification without fat inside in 3 of 35 cases (8.57%).The CT contrasted value was less than 20 HU in 26 of 35 cases (74.29%).Contrast-enhancing septa were present in 17 of 35 cases (48.57%).The enhancing septa corresponded to loose connective tissue between cartilaginous core.Pathologically，all hamartomas had complete fibrouscapsule around them.Cartilage，broncheal gland，smooth muscle and fibrous connective tissue were found in all cases，and fat and calcification were found in 21(60%) and 12(34.29%) respectively.Conclusion Some specific CT features，including smooth edge，calcification and fat inside，are useful for diagnosis of pulmonary hamartoma.Dynamic contrast enhancement CT scanning is useful for 　　differentia