孤立性肺结节多层螺旋CT的征象鉴别

Differential Analysis of Solitary Pulmonary Nodules in Multi-slice CT Signs

目的 通过对孤立性肺结节（SPN）的CT形态学征象分析,探讨其在定性诊断中的价值.方法 回顾性分析经病理证实的117例SPN形态学征象,观察、分析其病理基础及形成原因,评价其定性诊断疾病的价值.结果 通过对各种征象的把握,CT对SPN诊断意义重大,在肺癌、肺转移瘤及肺结核瘤诊断中有较高的符合率（88 %、85.7%、81.5%）,而炎性假瘤的诊断正确率明显下降（64.7 %）.在各种征象提示中,血管集束征、方形征各自具有较高的特征性,空泡征、多结节聚集征、分叶征、毛刺征、棘突征、胸膜凹陷征对于提示肺癌的诊断也具有一定的意义.结论 综合把握征象的意义对于提高对SPN的诊断正确率有十分重要的意义.

Objective Through analyzing the morphological signs of solitary pulmonary nodule of CT,to evaluate the value of qualitative diagnosis. Method Analyzing the morphological signs of the 117 cases of SPN that proved by pathology,observing and analyzing the pathological bases and the reasons,evaluate the qualitative diagnosis＇ value of the disease. Result Through grasping various signs,there is great significance in SPN＇ s diagnosis by CT. In lung cancer, lung metastatic tumor and tuberculosis,the diagnostic accuracy is high（88%, 85.7%, 81.5%）, however,the diagnostic accuracy in inflammatory tumor decline significantly（64.7%）.ln various signs, bronchovascular convergence sign and square sign are characteristic signs.Vacuole sign,multi-nodule accumulation sign, lobulation sign,coarse spicules sign,spiculated sign,pleural indentation sign are a certain of significance. Conclusion Comprehensively grasping the significance of SPN＇ s signs is very important for improving the diagnostic accuracy of SPN disease.