MDCT靶扫描及后处理重建技术在肺部磨玻璃结节中的临床应用

Clinical application of MDCT scan and post process reconstruction in the pulmonary ground glass nodule

目的:探讨MDCT靶扫描及后处理重建技术在诊断肺部磨玻璃结节病变中的临床价值。方法:搜集2015年1月-2016年10月经MDCT扫描发现的磨玻璃结节40例,病变性质以手术或肺穿刺病理为参照;靶扫描参数:200KV,250MAs,层厚1mm,小显示野20-30cm;后处理重建技术包括:多平面重建技术、最大密度投影、最小密度投影、表面投影显示。结果:40例磨玻璃结节经过靶扫描均清晰显示且结节内见肺血管纹理影;结节直径3mm-20mm,平均直径12mm;结节边缘清晰10例、模糊30例;结节伴毛刺20例,伴分叶10例;结节局部支气管管壁不规则增厚僵硬、局部中断,呈截断征16例,结节伴钙化灶6例;最终病理证实40例磨玻璃结节中腺癌28例,炎性增生10例,结核2例。结论:MDCT靶扫描及后处理重建技术可以很好的显示结节形态、边缘、内部结构及邻近局部支气管的形态,对肺部磨玻璃样结节良恶性的判断有很大的帮助。

Objective：To explore the targeted multi detector CT（ MDCT） scanning and post-processing reconstruction of ground glass nodules（ GGN） in the diagnosis of lung disease in clinical application,to bring the image information more comprehensive and more accurate for the diagnosis of GGN CT.Methods：From January 2015-2016 years 10 menstrual CT scan showed ground glass nodules in 40 cases,the nature of the lesions eventually after surgery or lung puncture pathology;targeted CT scan parameters：200 KV,250 MAs,1 mm thickness,small field of view（ SFOV） 20-30 cm; postprocessing reconstruction techniques including multi planar reconstruction（ MPR） maximum density projection（ MIP）,minimum intensity projection（ Min IP）,Surface projection display（ SSD）.Results：40 cases of ground glass nodules after targeted CT scan can clearly show that the pulmonary vascular nodules in nodular texture shadow,clear edge in 10 cases,30 cases showed fuzzy edge; nodule diameter 3 mm-20 mm,average diameter of 12 mm; 20 cases with nodules with burr,lobulation in 10 cases; local nodular irregular thickening of bronchial wall stiff,local interrupt,a truncated sign in 16 cases,nodules with calcification in 6 cases; the final pathology confirmed 28 cases of adenocarcinoma in 40 cases of ground glass nodules,10 cases of inflammatory hyperplasia,2 cases of tuberculosis.Conclusion：Spiral CT targeted scanning and postprocessing reconstruction technique can display the nodular morphology,margin,internal structure and morphology of the adjacent local bronchus is very good,the pulmonary ground glass nodule benign and malignant judgment.