动态CT增强对结节样肺癌与结节样肺炎的鉴别诊断价值

The Clinical Value of Dynamic Enhanced CT in Solitary Pulmonary Nodules

目的研究动态CT增强扫描对结节样肺癌与结节样肺炎的定性价值。方法随机选择83例SPN患者，先行薄层（3．0-5．0mm）平扫，再静脉注射对比剂（优维显）100mL后，对选定的结节中心行动态CT增强扫描，测量其增强前后的CT值，并对其中47例行三维表面重建。结果肺炎性结节以重度强化为主，净增值〉60HU，动态曲线呈持续上升型；肺癌性结节以轻。中度强化为主，净增值为20-60HU，动态曲线呈缓慢持续升高型；三维重建成像显示：恶性结节以Ⅰ、Ⅱ型血管异常为主；良性结节以Ⅳ型血管异常为主。结论动态CT增强扫描中追加三维重建对孤立结节的鉴别诊断有较高价值。

Objective To evaluate the cinical of dynamic enhanced CT in solitary nodules （SPN）. Methods 83 SPNs were randomly selected,and thin section CT（3.0 -5.0 mm） scan firstly and scan through the center of the nodules after intravenous injection If 100 mL iodinated contrast media were performed, in which three dimensional surface reconstruction and CT value measurement before and after post - contrast were done in 47 cases. Results Markedly enhancement appeared mostly in inflammatory nodules, the increased CT value was more than 60HU and the dynamic curve represent uptrend;slight - moderate enhancement appeared mostly in lung cancer and the increased CT value varied from 20 to 60 HU, but its curve represent more flat than the inflammatory nodules;slight enhancement was seen in tubereuloma and the increased CT value was less than 20 HU. Type Ⅰ and Ⅱ of three dimensional reconstruction of nodules indicate maligmant. Type Ⅳ indicate benign. Conclusion Dynamic enhanced scanning is If great value in differentiating maligmeant nodules from benign ones.