CT同层动态增强扫描对肺内孤立性结节的鉴别诊断

Differential diagnosis of solitary pulmonary nodules by using single-location dynamic enhanced CT

目的:探讨CT同层动态增强扫描鉴别肺内良、恶性结节的临床价值。方法:利用CT同层动态增强扫描方法对39例肺内孤立性结节(SPNs)患者的不同增强模式进行分析,并绘制SPNs强化的时间-密度曲线、测量其强化峰值和CT净增值。结果:良、恶性结节强化后具有不同的时间-密度曲线模式和CT净增值。肺癌的CT净增值[(41·9±2·8)]Hu高于结核的CT净增值[(11·7±7·85)Hu](P<0·01);炎性结节的CT净增值[(43·6±7·7)Hu]与肺癌的CT净增值比较差异无显著性(P>0·05)。但肺癌的时间-密度曲线为初始急剧上升后缓慢下降,最后保持稳定水平;炎性结节曲线呈持续上升(无下降)趋势;肺结核的曲线呈平缓走行,无明显起伏。结论:CT同层动态增强扫描是用一种无创性方式对SPNs血流模式提供定量信息。

Objective To study the clinical efficacy of differential diagnosis between malignant and benign solitary pulmonary nodules （SPNs） with single-location dynamic enhanced computed tomography （CT）. Methods Thirtynine patients were studied with single-location dynamic enhanced CT. Patterns of time-density curve were drawn. Peak height and increment of CT value were calculated. Results Malignant and benign SPNs showed quite different patterns in time-density curve. Enhanced degree of pulmonary carcinoma [ （41.9±2.8） Hu] was higher than that of the tuberculosis [ （11.7±7.85） Hu], which had significant difference （P〈0.01）. However, here was no significant difference of enhanced degree between pulmonary inflammatory [ （43.6 ± 7.7） Hu] and pulmonary carcinoma SPNs （P〉0. 10）. But the time-density curve of malignant SPNs tend to achieve rapid enhancement- topeak attenuation and eventually reached a plateau. Inflammatory SPNs showed gradual enhancement without obvious attenuation. The curve of tuberculosis was placid. Conclusion Single-location dynamic contrast enhanced CT is a non-invasive option and can provide quantitative information about blood flow patterns of SPNs.