螺旋CT动态增强扫描诊断孤立性肺结节病灶的研究

The Research of Dynamic Enhanced CT in the Diagnosis of Solitary Pulmonary Nodules

目的评价螺旋CT动态增强扫描对孤立性肺结节(SPN)的诊断价值。方法对经手术、病理证实的孤立性肺结节病患者40例,行螺旋CT动态增强扫描,分析最大强化值及时间-密度曲线。结果肺癌和炎性假瘤的最大强化值与结核瘤有显著性差异。恶性结节的强化明显高于良性结节(P<0.01)。以强化值20HU为阈值,敏感性100%(26/26例恶性结节),特异性42.8%(6/14例良性结节),准确性85%(34/40例肺结节)。结论强化值≤20HU,提示为良性结节;螺旋CT能准确判断SPN的强化程度和类型,能够提高SPN的诊断准确率。

Objective To evaluate contrast - enhanced spiral CT in diagnosing solitary pulmonary nodules （SPN） .Materials and Methods 40 patients of pulmonary nodules proved pathologically were performed with dynamic enhanced CT to analyze peak net nodule enhancement and time- attenuation curves.Results The maximum enhancement level in lung cancer and inflammatory nodule were significantly higher than that of tuberculoma.Malignant nodules were enhanced significantly more than benign nodules.With 20HU as the threshold,the sensitivity was 100% （26 of 26 malignant） ,the specificity was 42.8% （6 of 14 benign nodules）, the accuracy was 85 % （34 of 40 nodules）. Conclusion Lung nodules enhancement less than 20HU at contrast- enhanced CT is strongly predictive of benignity.Contrast - enhanced spiral CT scanning can precisely enhancement degree and pattern of SPN, which improves the diagnostie accuracy of SPN.