肺癌性与肺结核性结节的同层动态CT增强扫描研究

Diagonosis of peripheral pulmonary carcinoma and tuberculoma by single-location dynamic enhanced CT

目的评价同层动态CT增强扫描对肺癌性与肺结核性结节的鉴别诊断价值。方法选择周围型肺癌41例和肺结核球20例,病灶平扫后静脉注入对比剂,行同层动态增强CT扫描,测量增强前后病灶CT值,计算最大净增值,并观察其强化类型。结果周围型肺癌与肺结核球平扫时二者间无显著性差异(P>0.05);增强后除195 s外,二者间所有时间段的CT强化值均有显著性差异(P<0.05);二者的最大净增值亦有显著性差异(P<0.05)。周围型肺癌增强后各时间段强化值与其平扫CT值相比,皆有显著性差异(均P<0.05);肺结核球增强后各时间段强化值与平扫CT值相比无显著性差异(均P>0.05)。周围型肺癌的强化类型以中-重度结节状强化为主,肺结核球以无强化或轻度边缘性强化为主。结论同层动态CT增强扫描有利于周围型肺癌性与肺结核性结节的定性诊断。

Objective To evaluate the diagnostic value of single-location dynamic enhanced computerized tomography（CT） for peripheral pulmonary carcinoma and tuberculoma. Methods Single-location dynamic enhanced CT was performed on 41 patients with peripheral pulmonary carcinoma and 20 patients with tuberculoma. The CT values were compared before and after enhancement, and the enhancement type were observed. Results The degree of plane scan between peripheral pulmonary carcinoma and tuberculoma had no significantly difference （P 〉 0.05）. The average enhancement degree of peripheral pulmonary carcinoma was higher than that of tuberculoma on 15 s, 35 s, 75 s and 135 s （P 〈 0.05）. The enhancement degree of peripheral pulmonary carcinoma was higher than that of plane scan （P 〈 0.05）. There is no significantly difference between the degree of plane scan and enhancement scan of tuberculoma （P 〉 0.05）. Moderate to severe nodular enhancement was dominant in pulmonary carcinoma, while no or mild edge enhancement was dominant in tuberculoma. Conclusions Single-location dynamic CT is helpful in differential diagnosis of peripheral pulmonary carcinoma and tuberculoma.