多层螺旋CT靶扫描定性诊断孤立性肺结节

Targeted multislice CT scan in the qualitative diagnosis of solitary pulmonary nodules

目的 探讨多层螺旋CT(MSCT)靶扫描技术在孤立性肺结节(SPNs)定性诊断中的应用价值。方法 经手术病理、穿刺活检或随访证实的57例肺内孤立性结节,先行常规平扫后即时对结节进行靶扫描,对结节的形态、密度、内部结构、边缘及周围征象进行分析,获得定性诊断,其中7例结合增强扫描。结果 恶性肺结节42例(73.7%),表现为形态不规则、边缘分叶或/和毛刺征,密度不均,有空泡征或空气支气管征,胸膜凹陷征,血管集中征等,4 例增强扫描病例明显强化。良性肺结节15例(26.3%),表现结节边缘光滑锐利,密度较高而均匀,部分结节内可见钙化,增强扫描病例无或轻度强化。结论 MSCT靶扫描技术能够显示常规扫描不能显示的更多的肺结节的影像信息,是提高肺内孤立性结节定性诊断准确性的有效检查手段之一。

Objective To investigate the evaluation of targeted multislice CT (MSCT) scan in the qualitative diagnosis of solitary pulmonary nodules (SPNs). Methods A total of 57 cases of SPNs underwent conventional CT and targeted MSCT scan. The shape, density, inner, marginal, and surrounding signs of all SPNs were analyzed. Results Among 57 cases of SPNs, 42 cases (73.7%) were malignant SPNs, all presented irregular shape, lobulated or speculated edge, asymmetrical hyperdensity with vacuole sign, air-bronchogram, pleural retraction convergence of peripheral vessel and obvious enhancement (4 cases). Benign SPNs were found in 15 cases (26.3%), presented smooth edge, symmetrical hyperdensity with calcification with or without mild enhancement. Conclusion Targeted MSCT scan can show much more information of SPNs than convertional CT. It is one of the effective methods to improve the diagnostic accuracy of SPNs.