MSCT对恶性孤立性肺结节血管改变的研究

Study of the vascular appearance change of malignant SPN using multislice spiral CT

目的研究恶性孤立性肺结节(SPN)血管形态改变,并探讨MSCT诊断价值。方法分析41例直径≤3 cm SPN患者,采用多层螺旋CT(MSCT)层厚为2.5 mm螺旋靶扫描,经工作站行多平面重建(MPR)、曲面重建(CPR)、及容积再现(VR)后处理方法,重点显示SPN相关的血管形态改变,并与病理检查结果比较。结果 (1)41例恶性SPN中SPN-血管关系形态改变如下:Ⅰ型肺血管于SPN边缘被截断,一支或多支末端呈杵状增粗。Ⅱ型显示为血管切迹征。Ⅲ型肺血管延伸进入或穿过SPN。结论采用MSCT薄层螺旋靶扫描,结合MPR、CPR、VR等重组方法能准确显示恶性SPN-血管形态改变,对恶性SPN诊断有重要价值。

Objective To study the vascular appearance change of malignant SPN using multislice spiral CT and to explore the diagnostic value of MSCT. Methods MSCT continuous volume targeted scans of 2. 5 mm collimation with standard algorithm were performed and reconstructed imaging of MPR, CPR and VR in workstation in 41patients of SPN with ≤3 cm in diameter. The emphasis was paid on manifestation of the shapes and the patterns of SPN with related vessels, compared with the results of pathology. Results Among 41 patients of malignant SPN, The SPN-vessels relationship was identified as three types with MSCT. Type Ⅰ ： Vessels was ohstrucled abruptly by the SPN, and the end of one or more vessels was drumstick thickening, type Ⅱ ： Vascular notch sign was demonstrated, and Typc Ⅲ： Vessels penetrated into SPN. Conclusion Continuous volume targeted scan with MSCT and followed by MPR, CPR and VR reconstruction can accurately demonstrate vascular appearance change of malignant SPN, and it is valuable in the diagnosis of the nature of malignant SPN.