孤立性肺结节三维重建成像的CT研究

CT 3D Imaging of Solitary Pulmonary Nodules

目的 探讨三维重建成像对孤立性肺结节 (SPN)形态特征的显示及其良恶性的诊断价值。资料与方法 对 37例SPN(直径≤ 3cm)进行增强薄层扫描 ,利用三维成像软件用表面遮盖法 (SSD)进行三维重建。调整阈值上、下限 ,分别观察结节的表面形态及与相邻胸膜、支气管、血管的关系 ,分析三维形态学改变对鉴别其良恶性的诊断价值。结果 3DCT完整显示了 37例SPN立体形态和结节与周围血管的关系及血管类型 ,直观显示了 34例SPN相邻胸膜内外侧面形态改变和结节与周围支气管的关系。 3DCT形态分型 ,在良恶性SPN上有差异。结论 三维重建技术不仅能三维显示SPN的异常表现 ,而且能掌握肺结节与支气管、血管和胸壁间的解剖关系 ,充分、直观地显示SPN的形态学特征。 3DCT结合 2DCT有助于提高诊断准确性 ,是鉴别SPN良恶性的有效的影像学检查方法。

Objective To assess the value of contrast enhanced CT 3D imaging in differentiating benign solitary pulmonary nodules (SPN) from malignant ones. Materials and Methods Enhanced thin slice CT scanning was performed in 37 patients with SPN (diameter ≤3cm), and 3D reconstruction was made using SSD. By adjusting the lower and upper threshold of CT values, optimal surface features of the nodules and the adjacent structures, such as pleura, bronchi and vessels, were obtained respectively, and 3D images were evaluated for the differentiation of benign with malignant.Results 3D CT completely and stereoscopically demonstrated the lesion's morphology, as well as the relation to the adjacent vessels in all 37 cases. The inner and outer pleurae near the lesion and the relationship between SPN and adjacent bronchi were well displayed in 34 cases. A difference in pattern classification on 3D CT was found between benign and malignant SPN.Conclusion 3D CT can not only stereoscopically demonstrate the abnormal signs of SPN, but can also provide information concerning the anatomic relationship between SPN and adjacent bronchi, vessels and chest wall. Combined 3D with 2D CT, the diagnosis can be improved. 3D CT is an effective method for the differentiation of benign SPN with malignant lesions.