动态CT增强技术在孤立性肺结节中的诊断价值

The value of CT enhanced technology in diagnosis of solitary pulmonary nodules

目的探讨多层螺旋CT动态增强扫描对孤立性肺结节(SPN)的诊断价值。方法选取经病理证实的SPN患者153例,按病理分型分为良性组、炎性组和恶性组。采用GE Lightspeed 16排螺旋CT机对患者行平扫+动态增强扫描,应用GE ADW 4.3工作站的后处理技术及Perfusion3-body tumor软件对结节进行分析。比较各组间多期动态CT值,并绘制时间-密度曲线(TDC);比较各组CT增强后的最大净增值、各时间点CT净增值,并统计分析不同检查方法对诊断SPN的效能差异。结果恶性组增强后30 s时病变CT值明显高于良性组(P<0.05);炎性组增强后30 s、60 s、120 s、180 s、240 s、300 s时的病变CT值均明显高于良性组(P均<0.05);炎性组增强后60 s、120 s、180 s、240 s、300 s时的病变CT值均明显高于恶性组(P均<0.05)。良性组各期相CT净增值与最大净增值比较差异均无统计学意义(P均>0.05)。炎性组增强后15 s、30 s的CT净增值与最大CT净增值比较差异均有统计学意义(P均<0.05)。恶性组增强后15 s、30 s和60s的CT净增值与最大CT净增值比较差异均有统计学意义(P均<0.05)。结论多期动态CT增强扫描在良性、恶性及炎性SPN的鉴别诊断中有较高的应用价值,动态CT增强扫描较单纯CT平扫对SPN的定性诊断效能高。以增强后30 s、60 s及120 s作为扫描时间点较为合理。

Objective It is to investigate the value of contrast-enhanced CT scan for the diagnosis of solitary pulmonary nodules （SPN）. Methods One hundred and fifty-three cases of SPN patients were selected and divided into benign group,inflammatory group and malignant group according to pathological type. All the patients were examined by GE Lightspeed 16 - slice spiral CT machine for plain scan ＋ dynamic enhanced scan, GE ADW 4.3 workstation applications post-processing tech- niques and software Perfusion3 - body tumor nodules were use to analyze nodules, the CT values were obtained and TDC was drew to compare the obtained parameters, included maximum net value-added enhanced CT after CT net value added at each time point, and statistical analysis of different examination methods in the diagnosis of SPN ＇ s performance were performed. Results After enhanced for 30s, the CT value of malignant group was higher than that in benign group （P 〈 0.05） ; After enhanced for 30 s, 60 s, 120 s, 180 s ,240 s and 300 s the CT values in inflammatory group were higher than that in benign group （P all 〈 0.05） , and the value was also higher than that in malignant group except that in enhanced for 30 s （P 〈 0. 05 ）. There was no statistical difference between the net value and maximum net value of benign SPN in each phase CT（ P 〉 0.05 ）. There was statistically significant between the inflammatory SPN max increased CT value with 15 seconds and 30 seconds CT value（P all 〈0.05）. There was statistically significant between malignant SPN max increased CT value and 15 seconds, 30 seconds and 60 seconds CT value（P all 〈 0.05）. Conclusion Multi phase dynamic enhanced CT scanning has high application value in the differential diagnosis of benign, malignant and inflammatory in SPN, dynamic enhanced CT scanning was plain CT qualitative diagnosis of SPN high efficiency. In order to enhance after 30 seconds, 60 seconds and 120 seconds as the scanning time was reasonable.