非钙化性肺癌结节的动态CT增强与病理对照研究

Contrast-enhanced dynamic CT of noncalcified pulmonary carcinoma and pathological contrast

目的评价同层动态CT增强扫描技术对非钙化性肺癌结节的诊断作用。方法选择本院2000年5月至2005年5月经病理证实的原发周围型肺癌43例,分别为腺癌28例(包括细支气管肺泡癌9例),鳞癌10例,腺鳞癌2例,小细胞未分化癌、鳞腺癌及黏液表皮样癌各1例。所有病例行同层动态CT增强扫描,并与同期行动态CT增强的肺结核球15例进行对照研究。结果CT增强前非钙化性肺癌结节与肺结核球的CT值差异无统计学意义(P>0.05)。非钙化性肺癌结节增强后各时间段强化值与增强前比较差异均有统计学意义(P<0.05);非钙化性肺结核球增强后各时间段强化值与增强前比较差异无统计学意义(P>0.05)。结论同层动态CT增强扫描技术对良、恶性肺结节,尤其是非钙化性肺癌与肺结核瘤的鉴别诊断作用较大,可明显提高肺癌性结节的定性准确率。

Objective To evaluate the value of single-location dynamic CT of noncalcified pulmonary carcinoma. Methods Forty-three primarily peripheral lung cancer confirmed by pathology from May,2000 to May,2005 were randomly selected, in which there were 28 adencarcinoma（ including 9 bronchioalveolar carcinoma）,10 squamous carcinoma,2 enosquamous carcinoma, 1 small cell aplastic carcinoma, 1 adeno-squamous carcinoma and 1 myxo-epidermoid carcinoma. Dynamic enhanced CT were applied to them, and the results were compared with 15 pulmonary tuberculoma. Results No significant difference was found between the CT value of noncalcifled pulmonary carcinoma and tuberculoma before enhancement（ P 〉 0.05 ）. Significant difference was found between the CT value of before enhancement and after enhancement in noncalcified pulmonary carcinoma （P 〈 0. 05 ）. No significant difference was found between the CT value of before enhancement and after enhancement in noncalcified pulmonary tuberculoma （ P 〉 0. 05 ）. Conclusion Single-location enhancement is of great importance in differentiating benign and malignant pulmonary nodules, especially in noncalcified pulmonary carcinoma and tuberculoma. It can improve the accuracy of diagnose of pulmonary carcinoma significantly.