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不典型肺错构瘤的CT表现及误诊分析

CT manifestations and misdiagnosis of atypical pulmonary hamartoma
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摘要 目的分析不典型肺错构瘤的影像表现,了解误诊原因并提高诊断的正确率。方法回顾性分析经病理证实的18例CT误诊的不典型肺错构瘤影像学征象并进行双盲分析,观察病灶部位、大小、边缘、边界、密度、强化特点,其余肺组织情况以及患者发病年龄、病史、临床表现等。结果共选取肺错构瘤患者18例,其中男9例,女9例。所有18例患者均行胸部CT扫描,其中平扫2例,增强扫描16例。18例肺错构瘤病例中,气管内病变3例,其中左主支气管1例,右中及右上支气管各1例,后2例病灶内可见钙化密度且继发相应肺段不张;周围型病变15例,其中右肺结节7例,左肺结节8例,所有周围型病例均为单发且均未见钙化及脂肪密度。病变直径0.3~2.1cm。其中光滑圆形孤立结节5例,浅分叶10例。16例增强扫描中,1例表现为明显强化,轻中度强化6例,无明显强化9例。结论肺错构瘤CT表现缺乏特征性,是导致误诊的主要原因。了解其多样化的影像表现,包括边缘浅分叶、边缘毛糙、异常强化等,有助于减少误诊。 Objective To analyze the CT imaging features of atypical pulmonary hamartomas,so as to understand the causes of misdiagnosis and improve the accuracy of diagnosis.Methods 18 cases with atypical pulmonary hamartomas confirmed by pathologyin our hospital were collected retrospectively,including 9 males and 9 females.18 cases were examined by chest CT scans,among which,2 cases with plain scans,and 16 cases with enhanced scans.The results of CT imaging were analyzed by two associate chief radiologists with double blind method,observing the lesion location,size,edge,border,density,enhancement features,the remaining lung tissue,the age of onset,history,and clinical manifestations.Results In all 18 cases,3 cases were endotracheal lesion,of which 1 case was in left main bronchus,the other two were in right middle and upper bronchus respectively,showing calcification density andsubsequent atelectasis;15 cases were peripheral lesions,including 7 cases presenting right pulmonary nodules and 8 cases presenting left pulmonary nodules.All peripheral cases were solitary pulmonary nodules without calcification and fat density.The diameter of nodules ranged from 0.3 cm to 2.1 cm.5 cases showed smooth round isolated nodules and 10 cases showed shallow lobulated nodules.In 16 cases of enhanced scan,1 lesion showed remarkable enhancement,6 lesions showed slightly enhancement,and 9 lesions showed no significant enhancement.Conclusion Pulmonary hamartoma is lack of characteristic of CT imaging,which is the main reason of misdiagnosis.Recognizing its diverse image performances including shallow lobulation,rough edge,remarkable enhancement and etc.helps us avoid misdiagnosis.
作者 刘佳琦 洪顺达 姜建 周福庆 何来昌 龚洪翰 曾献军 LIU Jiaqi;HONG Shunda;JIANG Jian;ZHOU Fuging;HE Laichang;GONG Honghan;ZENG Xianjun(Department of Radiology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)
出处 《实用放射学杂志》 CAS 北大核心 2019年第5期730-733,共4页 Journal of Practical Radiology
关键词 肺错构瘤 误诊分析 计算机体层成像 pulmonary hamartoma misdiagnostic analysis computed tomography
作者简介 刘佳琦(1994-),女,江西省赣州市人,在读硕士。研究方向:CT、MRI诊断,疼痛对脑功能及结构影响;通信作者:姜建,E-mail:jij2002cn@126.com.
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