MSCT高分辨动态增强扫描在肺内孤立性结节的诊断价值

The Value of High Resolution Enhanced Spiral CT in the Diagnosis of Pulmonary Solitary Nodules

目的评价MSCT高分辨动态增强扫描在诊断肺内孤立性结节的价值。方法收集直径小于3cm的肺内孤立性结节患者43例,其中周围性肺癌25例,单发转移瘤5例,肺炎性假瘤4例,结核瘤3例,肺硬化性血管瘤2例,肺腺瘤2例、肺错构瘤2例。43例患者先行常规CT扫描,然后行兴趣区高分辨螺旋CT动态增强扫描。结果高分辨螺旋CT动态增强扫描诊断肺内孤立性小结节的正确率为90%,肺内恶性结节大多均匀增强,且增强CT值大于20Hu,平均增强CT值为36Hu。良性结节多周边增强,且增强CT值小于10Hu。结论根据病变的基本形态特征,并结合高分辨螺旋CT动态增强扫描有助于肺内孤立性结节的定性诊断。

Objective To evaluate the diagnostic value of high resolution enhanced spiral CT in small pulmonary solitarynodules （SPNs） . Methods The plain spiral and contrast enhanced CT date of 38 patients with SPNs less than 3cm indiameter confirmed by pathology were retrospectively studied among which 29 cases presented with peripheral lung cancers with metastatic tumor 5 with in flammatory masses of the lung ,3 with nodul tuberculomas 2 with hamartoma 2 with hemangiomaand. Results The accuraterate of high resolutionen enhanced spiral CT for diagnosis of SPNs was 90%.The mean value of enhanced CT with malignant SPNs and benign ones were 36 Hu and 9Hu respectively.Most malignant SPNs showed homogeneous enhancement. The enhanced CT value was more than 20Hu.The benign ones were heterogeneous enhancement. The enhanced CT value was less than 10Hu. Conclusion High resolution enhanced spiral CT examination makes it possible to distinguish malignant SPNs from benign ones in most situations.In the same time we emphasize that the features of imaging morphology of SPNs have important value in differ- entiating malignant SPNs from benign ones.