孤立性肺结节动态增强CT的临床研究

The Clinical Research of Dynamic Contrast-enhanced CT in Solitary Pulmonary Nodules

目的探讨孤立性肺结节(SPN)的动态增强CT的临床疗效价值。方法选择2007年2月-2009年2月收治的SPN患者68例,并行动态增强CT扫描。对动态CT扫描图像进行分析,建立时间一密度曲线(TAC),测量SPN增强前后CT值,记录增强峰值(PH)、SPN与主动脉PH的比值(SPH/PPH)。结果CT强化值恶性结节与良性结节比较差异有极显著性(P<0.01),恶性结节与炎性结节比较差异无显著性(P>0.05),良性结节与炎性结节比较差异有显著性(P<0.01)。结论动态增强CT扫描有助于鉴别孤立性肺结节的性质,结节增强值在20HU以下提示良性,结节增强值≥20 HU,可作为诊断恶性结节的一个参考指标。CT动态增强扫描各延时像测量层面一致性的优化可进一步客观反映SPN的动态增强情况,有利于其形态学的比较及CT值的测量,有望提高其对孤立性肺结节鉴别诊断能力。

Objective To study the clinical efficacy value of the dynamic contrast-enhanced CT in the solitary pulmonary nodule （SPN）.Methods 68 cases of patients with SPN during the time from February 2007 to December 2009 were underwent with the dynamic contrast-enhanced CT scan.CT scan images of the dynamic were analyzed,and the establishment of temporal density （TAC） were measured before and after the CT enhanced.The CT Value of SPN after the enhanced,the value of the peak enhancement （PH）, the specific value of the SPN and the aorta PH （SPH/PPH） were recorded.Results Between the numbers of enhanced CT of malignant colorectal section and the benign nodule,it had statistically significant differences （P〈0.01）,between the malignant nodule and inflammatory nodule,it had no significant difference（P〉 0.05）, there were no statistical difference significance between the benign nodules and inflammatory nodules（P〈0. 01）. Conclusions Dynamic contrast-enhanced CT scan can help to identify isolated nature of pulmonary nodules,the numbers of nodular enhance were 20 HU,following tips in benign nodules enhance the value of =20 HU,the diagnosis of malignant nodules can be used as a reference.Dynamic contrast-enhanced CT scan measurement of the delay as the optimal level of consistency of the objective can be further enhanced to reflect the dynamics of SPN,the favorable comparison of its morphology and the measurement numbers of CT,is expected to increase their solitary pulmonary nodule diagnosis capacity.