64MSCT三维重建技术对孤立性肺结节的诊断价值

Value of three dimensional reconstruction technique of 64MSCT in diagnosing isolated pulmonary nodules

目的探讨64MSCT三维重建技术对孤立性肺结节(solitary pulmonary nodules,SPN)的影像学诊断价值。方法收集孤立性肺结节病例93例,其中选择结节直径≤3cm的40例入组,所有入选的40例病例均经手术、病理或临床随访证实,良性病变20例,恶性病变20例,通过多平面重组(Multi-planar reformation,MPR)、多曲面重组(Cured planar reformation,CPR)、容积再现(Volume rendering,VR)等重建方法,对孤立性肺结节与相邻血管束、支气管、胸膜之间关系的显示图像进行分析,经卡方检验,比较良、恶性结节的血供特点、与周围支气管、胸膜的差异性。结果良、恶性孤立性结节的血供特点与周围支气管、胸膜比较差异均有统计学意义(P<0.01);血供较丰富为主表现的恶性占85%,良性仅占15%;支气管中断或里杯口状为主表现的恶性占75%,良性未见该征象;胸膜凹陷征为主表现,恶性占80%,良性占15%。结论联合64MSCT的多种重建方法对孤立性肺结节的良恶性鉴别诊断有较高价值。

Objective To discuss the main imaging features of isolated pulmonary nodules on three dimensional reconstruction technique of 04MSCT in order to improve the diagnosis of benign and malignant nodules. Methods Ninety-three cases with separated pulmonary nodules were surveyed from March of 2010 to June of 2012 ad 40 cases with nodules size diameter ≤ 3cm and confirmed pathologically and imagingly and surgically were selected for observation, including 20 benign cases and malignant cases. The correlation of the separated nodules with the adjacent blood vessel bundle, bronchus and pleural were analyzed by reconstruction of MPR（multi-planar reformation）,CPR （cured planar reformation）,VR （volume rendering. The features and differences of blood supplying in benign and malignant nodules and bronchus around and pleural were also investigated. Results The blood supplying fdatures the separated nodules and the relationship between nodules and the adjacent bronchus and pleural in the benign cases and malignant cases showed significant differences （ P 〈 0.01）. It showed that 85% of the nodules characterized by rich blood supply were malignant and 75% of those manifested of bronchial disruption or in cup - shaped were malignant., 80% of the nodules mainly showed sign of pleural indentation were malaignant. Corlelusion Reconstruction methods of 64MSCT showed high value in qualitative diagnosing of malignant and benign separateed pulmonary nodules.