目的：探讨周围型肺错构瘤的HRCT特征及其病理基础，以期提高诊断准确率。材料和方法：回顾性对照研究25例经手术和病理证实的周围型肺错构瘤的HRCT及其病理表现。结果：所有肺错构瘤均单发，右肺14例，左肺11例；24例病灶贴近胸膜(96％)，距胸膜平均距离为0.64cm。余1例距胸壁为4.4cm。病灶呈圆形或椭圆形，边缘清晰锐利，12例见分叶征(48％)，7例见一条血管影进入病灶(28％)。HRCT显示4例含脂肪成分(16％)，9例有钙化(36％)(其中4例为爆玉米花样钙化)。术前HRCT诊断正确者16例(64％)。病理上所有病灶均有完整的纤维包膜，23例(92％)见软骨、腺体、平滑肌和纤维结缔组织等结构，11例(44％)见不同程度的脂肪成分，8例(32％)见不同程度的钙化。结论：周围型肺错构瘤的HRCT表现有一定特征，病灶边缘清楚，内含脂肪和钙化有助于正确诊断。%Purpose: For improvement of diagnostic accuracy, HRCT and pathological characteristics of peripheral pulmonary hamartoma (PPH) were evaluated. Materials and Methods: A correlative study of HRCT and pathologic findings of 25 cases with PPH was carried out retrospectively. Results: All 25 cases had a solitary PPH. Fourteen and 11 of 25 lesions were located in right and left lung respectively. Twenty-four PPHs(96% ) were found just under the pleura, and the average distance between the pleura and PPH was 0.64cm. Another one (4%) was located 4.4cm away from the pleura. All lesions were round or oval in shape. Margins of lesions were clear - cut in all cases, and in 12 of them (48%) were lobular. A vessel entering into the mass was seen in 7cases (28%) . Fat was shown in 4 cases (16%) .Nine hamartomas (36%) had calcifications, and 4 of them (16%) had a “popcorn” sign. Sixteen cases (64 % ) were correctly diagnosed with HRCT pre - operatively. Pathologically, PPH consisted of cartilage, gland, smooth muscle and fibrous connective tissue in 23 cases (92%),and fat and calcium were found in 11 (44%) and 8 (32%) cases respectively. PPH had a complete fibrous capsule around in all 25 cases. Conclusion: Certain specific CT features of PPH, including clear - cut margin, calcification and fat inside etc, are very useful for correct diagnosis of PPH.
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