肺内孤立性结节的CT诊断

CT DIAGNOSIS OF SOLITARY PULMONARY NODULES

目的探讨肺内性质不同且为孤立性结节（SPN）的CT表现。方法回顾性分析我院2002年3月～2006年11月间经手术证实肺内孤立性结节病灶的病例83例，所有病例术前行常规CT及高分辨率CT（HRCT）扫描，其中51例行增强扫描；统计其CT诊断与穿刺或手术后病理诊断的符合率。结果83个结节中，恶性结节36例；其中支气管肺癌28例，类癌3例，孤立性转移瘤5例。良性结节47例；其中炎性结节19例，结核球13例，错构瘤7例，血管性病变2例，支气管囊肿4例，盘状肺不张和脂肪瘤各1例。单纯普通CT扫描的良恶性诊断符合率为70％（58例），而普通CT扫描加HRCT和（或）增强扫描的诊断符合率为90％（75例）。结论对于孤立性结节的诊断，检查手段极其重要，在普通CT扫描的基础上，结合增强扫描及HRCT表现特点进行综合分析可以做出正确率较高的诊断。

Objective To explore the effects of CT diagnosis of solitary pulmonary nodules（SPN）. Methods 83 cases of SPN confirmed by operations underwent CT and high-resolution CT（HRCT） scannings. 51 cases received contrast-enhanced CT scanning. Rtrospective analyses were made to determine the coincidence of CT diagnosis and puncture of postoperative pathological analysis. Results 36 Cases were of malignant tumors including 28 cases of broncho-pulmonary cancer, 3 cases of carcinoid cancer and 5 cases of solitary transfer tumor. 47 cases were benign ones including 19 inflammatory nodules, 13 cases of tuberculoma, 7 cases of hamartoma, 2 cases of vascular lesion,4 cases of bronchial cyst, 1 case of plate-atelectasis and 1 case of lipoma. The coincidence was 70% （58 cases） with CT diagnosis, while combined use of CT and HRCT or contrast-enhanced scanning had the coindence of 90% （75 cases）. Conclusion Combined use of CT and contrast-enhanced scanning or HRCT can produce high rate of diagnoses of SPN.