摘要
目的 评价螺旋CT动态增强薄层扫描对孤立性肺结节 (SPN)的诊断价值。资料与方法 回顾性分析 79例经手术病理和临床观察证实的SPN患者的CT资料 ,其中周围型肺癌 4 7例 ,结核瘤 2 3例 ,炎性结节 7例 ,错构瘤 2例。在静脉注射碘对比剂 10 0ml(3.5ml/s)前后 ,对病灶进行一系列薄层扫描 ,测量增强前后各扫描层面的CT值 ,计算结节的最大强化CT值和SPN/Ao值 ,描绘结节的时间 密度曲线 ,分析结节的强化类型。结果 肺癌和炎性结节的最大强化值与结核瘤有非常显著性差异 ;肺癌和炎性结节的SPN/Ao值与结核瘤有非常显著性差异 ;肺癌和炎性结节的最大强化CT值和SPN/Ao值无显著性差异。肺癌和炎性结节的各时相强化值在注射碘对比剂 4 0s、2min无显著性差异 ,在 5min、8min有显著性差异。平扫 3组间CT值无显著性差异。 32例肺癌、5例结核瘤、2例炎性结节呈不均匀强化 ;12例肺癌、2例炎性结节呈均匀强化 ;3例肺癌、6例结核瘤和 2例炎性结节呈周围型强化 ;9例结核瘤和 1例错构瘤呈包膜样强化 ;1例炎性结节、3例结核瘤和 1例错构瘤无强化。结论 螺旋CT增强薄层扫描能准确判断SPN的强化程度及类型 。
Objective To evaluate contrast enhanced dynamic thin section spiral CT in diagnosing solitary pulmonary nodules (SPN).Materials and Methods Spiral CT findings in 79 patients with pathologically proved SPN (diameter≤3.0cm) were retrospectively analyzed. The lesions included primary peripheral lung cancer (n=47), tuberculoma (n=23), inflammatory nodule (n=7) and hamartoma (n=2). Serial thin section spiral CT scanning was performed just before and after the injection of 100ml iodinated contrast agent with the rate of 3.5 ml/s. CT numbers of each nodule before and after contrast administration was estimated. The maximum enhancement level of each nodule was recorded, and the SPN to aorta CT value ratio was calculated. The time attenuation curve of the nodule was traced and the enhancement pattern of the nodule was classified.Results Both the maximum enhancement level and SPN to aorta ratio in lung cancer and inflammatory nodule were significantly higher than that of tuberculoma. Between lung cancer and inflammatory nodule, no statistically significant difference in maximum enhancement level, SPN to aorta ratio was found. For enhanced CT number after contrast administration between lung cancer and inflammatory nodule, significant difference was seen at 5 and 8 min. although no significant difference was seen at 40 sec. and 2 min. No difference in CT value on plain scans was found between lung cancer, inflammatory nodule and tuberculoma. Heterogeneous enhancement appeared in lung cancer (n=32), tuberculoma (n=5) and inflammatory nodule (n=2), and homogeneous enhancement was also seen in lung cancer (n=12) and inflammatory nodule (n=2). Peripheral enhancement was seen in lung cancer (n=3), tuberculoma (n=6) and inflammatory nodule (n=2), and capsular enhancement in tuberculoma (n=9) and hamartoma (n=1). One inflammatory nodule, 3 tuberculomas and one hamartoma showed no enhancement.Conclusion Contrast enhanced dynamic thin section spiral CT scanning can precisely display enhancement degree and pattern of SPN, which improves the diagnostic accuracy of SPN.
出处
《临床放射学杂志》
CSCD
北大核心
2003年第1期22-26,共5页
Journal of Clinical Radiology
