多期动态CT增强扫描平台型强化方案对孤立性肺结节的诊断效能

Platform-type enhanced program of multi-phase dynamic enhanced CT in diagnosis of solitary pulmonary nodules

目的探讨多期动态CT增强扫描平台型强化方案对孤立性肺结节（SPN）的诊断效能。方法选取80例肺内SPN病例作为实验组,行CT平扫及平台型强化方案多期动态CT增强扫描,绘制时间-密度曲线（TDC）,观察曲线形态及对比剂到达峰值时间（TTP）。随机选取同期SPN病例80例作为对照组,行常规增强扫描。对两组的CT影像诊断符合率进行比较。结果实验组中肺癌52例,炎性结节12例,肺结核16例,三者间平扫、增强后各时间点CT值及最大净增值差异均有统计学意义（P均20HU且0.05）。结论多期动态CT增强扫描平台型强化方案对SPN的诊断及鉴别诊断具有较高的应用价值。

Objective To explore the diagnostic efficacy of platform-type enhanced program of multi-phase dynamic enhanced CT scan for solitary pulmonary nodules（SPN）.Methods A total of 80 cases with SPN were selected who underwent unenhanced and multiphase dynamic enhanced CT scanning were considered as an experimental group.The time-density curve（TDC）was draw,and the peak time（TTP）of contrast agent was observed.Another 80 cases of SPN in the same period were considered as control group who underwent the conventional enhanced scan.The rate of diagnostic coincidence was compared.Results The experimental group included of 52 cases of lung cancer,12 cases of inflammatory nodules in lung and 16 cases of pulmonary tuberculosis.There were statistically significant differences in unenhanced and enhanced CT values and the maximum net-increased value of CT enhancement among the three groups（P0.05）,and there were also significant differences between any two groups（P0.05）.Step-type of TDC curve was observed in 52 cases of lung cancer,10 cases of inflammatory nodule,and 1case of tuberculosis.Two cases of inflammatory nodules showed bimodal,15 cases of tuberculosis flat,and there was a statistically significant difference（χ~2=85.026,P0.001）.Regarding the maximum net-increased value of CT enhancement20HU and 60 HU as the diagnostic threshold of malignant SPN,the sensitivity of CT diagnosis in experimental group was 94.23%（49/52）,the specificity was 89.29%（25/28）,the consistent rate was 92.50%（74/80）.The consistent rate of CT diagnosis at the 64s（74/80,92.50%）in experimental group was compared with the consistent rate of CT diagnosis at the 30s（70/80,87.50%）and 120s（71/80,88.75%）in control group.The difference was not statistically significant（both P0.05）.Conclusion Platform-type enhanced program of multi-phase dynamic enhanced CT scan has a higher value in diagnosis and differential diagnosis of SPN.