目的：探讨多层螺旋CT对肺硬化性血管瘤（PSH）诊断的临床应用价值。方法回顾性分析19例经手术及病理证实的肺硬化性血管瘤的MSCT表现及术前诊断准确率。其中9例行CT平扫，2例行CT直接增强扫描，8例行CT平扫及增强扫描。对图像进行薄层重建及多平面重组（MPR）。结果19例均为单发实性边界清晰类圆形肺结节或肿块，平均直径23mm，分布无偏向性。其中8例（42.1%）见斑点状钙化灶，4例（21.1%）见分叶，3例（15.8%）见空气新月征，4例（21.1%）病灶跨叶间胸膜生长，1例（5.26%）见胸膜牵拉凹陷，8例（8/10，80%）增强CT扫描显示贴边血管征。本组术前定位诊断准确率为100%，本组术前定性诊断准确率为68%。结论MSCT薄层及MPR可清晰的显示PSH的形态学及结构特点，贴边血管征有助于本病的诊断，MSCT在肺硬化性血管瘤的定位及定性诊断中具有很高的临床应用价值。%Objective To discuss the clinical application value of multi-slice spiral CT (MSCT) in diagnosis of pulmonary sclerosing hemangioma (PSH).Methods MSCT features and preoperative diagnostic accuracy were retrospectively analyzed of 19 patients with pathologically proven PSHs after surgery. 9 patients were performed with routine CT scan, 2 patients were performed with directly enhanced CT scan, and 8 patients were performed with routine and enhanced CT scan. Finally, thin layer reconstruction and multiplanar reformation(MPR) were conducted to the images.ResuIts All of 19 images in our study presented solitary pulmonary nodules or masses with a mean diameter of 23 mm and equal distribution. 8 patients (42.1%) had calcifications. 4 images (21.1%) had lobulations. 3 images (15.8%) had air meniscus signs. 4 images (21.1%) showed the tendency to grow across the pleural membranes. And only one image (5.26%) showed pleural indentation sign. 8 images (80%) conducted with enhanced CT scan showed vascular welt signs. The preoperative localization diagnosis accuracy rate was 100% and the preoperative qualitative diagnostic accuracy rate was 68% in this group.ConcIusionThe morphological and structural features of PSH can be seen clearly in MSCT thin layer and MPR. And welt vessel signs can be helpful to the diagnosis of PSHs.MSCT has high clinical application value in the diagnosis of PSH.
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