肺癌螺旋CT动态增强扫描的影像学表现(附30例分析)

The imaging findings of pulmonary carcinoma at helical incremental dynamic CT (with an analysis of 30 cases)

目的观察肺癌的血供变化,找出它的一些特征和规律,为诊断和鉴别诊断提供更多信息。方法采用东芝螺旋CT机对115例肺部单个结节进行动态增强扫描,总结分析经手术证实的肺癌30例。结果30例肺癌中轻度强化2例,中度强化14例,高度强化5例,显著高度强化2例,无强化7例。肺癌最高强化值开始出现在18～28s7例,30～39s12例,40～44s3例,平均32s。结论肺癌的强化多呈中度和高度强化,强化最高值开始出现的时间在1min内,多在注射造影剂后约32s左右。肺癌的强化与肺结核球和炎性假瘤不同。肺结核球多数不强化,部分结核球环状强化,强化环较薄且均匀。部分肺癌的环状强化为肿瘤周围肺不张强化。炎性假瘤的强化多呈显著高度强化,最高强化值超过100HU,强化程度比肺癌显著,最高强化值开始出现的时间变化较大,可在1min内,也可在1min后。

Objective To investigate the characteristic findings of pulmonary carcinoma at helical incremental dynamic CT, which is correlated to the nature of its blood supply, in order to improve the accuracy of the diagnosis and differential diagnosis. Methods 115 patients with solitary pulmonary nodule undertook incremental dynamic scan with Toshiba XPRESS/SX CT scanner. CT images was studied in 30 cases of out of 115 were pulmonary carcinoma, proved by operation and pathology. Results Mild enhancement was found in 7 cases out of 30; moderate enhancement was revealed in 14 cases; apparent enhancement was noted in 5 cases; remarkable high enhancement was yielded in 2 cases; while no remarkable enhancement could be detected in 7 cases. The enhancement reached its peak at 18- 28 seconds after administration of the contrast agent in 7 cases; at 30 -39 seconds in 12 cases; and at 40 -44 seconds in 3 cases. The average time of the enhancement peak was at 32 seconds. Conclusion A pulmonary carcinoma is commonly mildly or moderately enhanced. The enhancement peak comes within 1 minute （about 32 seconds） after the contrast agent is given. The enhancement of pulmonary carcinoma is different from that of tuberculoma and inflamatory pesudotumor. A typical tuberculoma is a non -enhanced nodule and in some uncommon cases, a thin, regular rim enhancement may be revealed. Rim enhancement is evident in some lesions of pulmonary carcinoma, which results from the enhancement of peri - tumor atelectasis. Remarkable brilliant enhancement is commonly seen in inflammatory pesudotumor, with the peak CT value over 100 HU. The enhancement reaches its peak in a larger range of time, which can be shorter or longer than.