孤立性肺结节的CT与病理检查结果对比研究

Comparison between the results from CT and pathological examination on solitary pulmonary nodule

目的:探讨孤立性肺结节(SPN)的CT表现与其良恶性的关系。方法:156例SPN患者均经过CT扫描,记录SPN直径,空泡、毛玻璃样改变(GGO)、棘突、毛刺、分叶、胸膜凹陷、血管集束征频数。增强扫描时绘制SPN时间-密度曲线,记录CT值峰值出现时期,CT值净增值(PH,CT值峰值-平扫CT值),然后切除SPN并行病检。对照CT与病检,总结CT结果与SPN性质的关系。结果:恶性SPN平均直径大于良性(P<0.05),空泡、GGO、棘突、毛刺、血管集束征的存在提示SPN恶性(P<0.05)。增强扫描时CT值峰值出现在静脉期,以轻中度方式增强时提示SPN恶性。结论:SPN直径越大恶性可能性越大,空泡、GGO、棘突、毛刺、血管集束征可作为恶性SPN的特异性征象。增强扫描可与CT征象互为补充,以便更准确地判断SPN性质。

Objective To investigate the relationship of CT findings with benign or malignant features of solitary pulmonary nodule （SPN）. Methods 156 patients with SPN underwent CT scanning and contrast enhancement. The nodule was resected and received pathological examination after the diameter of SPN and CT signs （the air bronchogram, GGO, speculated sign, burr, pleural indentation, lobulation, close the vessel convergence sign） were recorded and the peak high （peak value of CT-scanning CT value） and the time of peak value appearance were ascertained. The data were analyzed to summarize the relationship between CT findings and SPN features. Results The average diameter of malignant SPN was higher than that of benign SPN （P 〈 0.05）. The existence of air-bronchogram, GGO, speculate, burr, closing the vessel were related to malignant SPN （P 〈 0.05）. The peak value of CT appeared in the venous phase and reinforced with mild to moderate mode had a certain relationship with malignant SPN under contrast enhancement scans. Conclusion The higher the diameter of SPN, the more malignant the SPN was. The air-hronchogram, GGO, speculate, burr, closing the vessel can he used as the specific signs of malignant SPN. To determine the nature of SPN more accurately, the CT signs should be combined with contrast enhancement scans.