CT动态增强扫描对肺内孤立性小结节的鉴别诊断价值

THE VALUE OF DYNAMIC ENHANCED CT IN DIFFERENTIAL DIAGNOSIS OF SMALL SOLITARY PULMONARY NODULES

目的探讨动态增强CT扫描对肺内孤立性小结节的鉴别诊断意义。方法经手术病理证实肺内孤立小结节60例,其中小肺癌38例,炎性结节10例,结核球12例,术前均行CT平扫及注药后30 s、1 min、2 min、3 min、4 min、5 min6、min的动态增强扫描。根据病灶平扫CT值及不同时间增强扫描CT值,做出不同病变CT值的时间-密度曲线。结果小肺癌与结核、炎症的平扫CT值无显著差异。结核球的强化程度明显低于小肺癌和炎性结节,但炎性结节与小肺癌的CT强化程度无显著差异。小肺癌、炎性结节和结核球三种病变增强后的时间-密度-曲线形态和强化形式不同。结论动态增强CT扫描对肺内孤立性小结节鉴别诊断有一定意义。

Objective To investigate the dynamic enhanced CT scanning in differentiation of small solitary pulmonary nodules.Methods Sixty cases were confirmed by operation and pathology, 38 of the total were small lung cancer, 12 were tubereuloma, and 10 were inflammatory nodules. All cases were studied with plain chest CT scan and dynamic enhanced （the delay time of scans was 30 sand 1,2,3,1,5,6 min after injection） before surgery. Then the enhancement degree of the lesions was recorded at different dines. The time attenuation curves of different diseases were made. Results There was no significant difference in plain CT value among cancer, inflammatory and tuberculoma. Tuberculoma showed a significantly lower degree of enhancement than the cancer and inflammatory nodules. The carcinoma and the inflammation showed no difference in degree of enhancement. But the time attenuaution curves of the three kinds of lesions after injection of contrast medium appeared to be different and the en hancement modality of the three kinds of lesions were different too. Conclusion The dynamic enhanced CT scanning is of certain value to differential diagnosis of small solitary pulmonary nodules.