【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 2 5例肺错构瘤的CT平扫、17例无钙化错构瘤的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。结节内含有脂肪密度 (无钙化 )的 8例 ,占 3 2 % ,既有脂肪又有钙化的 6例 ,占 2 4% ,只有钙化的 2例 ,占 8%。增强扫描 ( 17例 )强化值 <2 0HU的 16例 ,占 88.2 4% ,强化形态呈间隔状强化 13例 ,占 76.47%。病理上 ,所有错构瘤都有完整的纤维包膜 ,13例有不同程度的脂肪 ,占 5 2 % ,8例可见到钙化 ,占 3 2 %。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更多还原

【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 25 cases of pulmonary hamartoma were analyzed. Dynamic contrast enhancement CT scanning were performed in 17 cases without calcification. All cases were confirmed by surgical operation and pathology.Results All hamartomas had smooth edge on CT. Focal fat without calcification inside were present in 8 of 25 cases, focal fat and calcification inside in 6 of 25 cases (24%), calcification without fat inside in 2 of 25 cases (8%). The CT contrasted value was less than 20 HU in16 of 17 cases (88.24% ). Contrast-enhancing septa were present in 13 of 17 cases(76.47%). The enhancing septa corresponded to loose connective tissue between cartilaginous core. Pathologically, all hamartomas had complete fibrous capsule around them. Cartilage ,broncheal gland, smooth muscle and fibrous connective tissue were found in all cases, and fat and calcification were found in 13 (52%) and 8 (32%) 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 differentiating pulmonary hamartoma with peripheral lung carcinoma.更多还原