孤立性肺结节的动态CT增强扫描特征分析

Analysis of the characteristics of solitary pulmonary nodules by dynamic CT enhanced scanning

目的探讨孤立性肺结节(SPN)的动态CT增强扫描特征。方法回顾性分析我院2017年5月~2019年5月收治的100例SPN患者的临床资料,其中肺癌患者62例,肺炎性结节患者30例,肺结核瘤患者8例。所有患者均行动态CT增强扫描,分析动态增强扫描SPN的强化表现、平扫与动态增强扫描病灶的CT值测量结果。结果62例肺癌患者中,不均匀强化32例,均匀强化29例,周围型强化1例;30例肺炎性结节患者中,不均匀强化18例,均匀强化12例;8例肺结核瘤患者均无明显强化,增强之后CT值增加<20 Hu。肺癌平扫CT值均小于增强各期CT值,差异有统计学意义(P<0.05);肺癌增强各期CT值比较,差异无统计学意义(P>0.05);肺炎性结节平扫CT值均小于增强各期CT值,差异有统计学意义(P<0.05);肺炎性结节增强30 s的CT值均低于增强60、120、180 s时的CT值,差异有统计学意义(P<0.05);肺炎性结节增强60、120、180 s时的CT值比较,差异有统计学意义(P<0.05);肺结核瘤平扫期、增强各期的CT值比较,差异均无统计学意义(P>0.05)。结论良恶性SPN具有独特的动态CT增强扫描强化特点,肺癌增强30 s内的时间-密度曲线属于明显上升型,肺炎性结节的时间-密度曲线属于逐渐上升型,肺结核瘤SPN的时间-密度曲线属于平坦型。

Objective To investigate the characteristics of solitary pulmonary nodules(SPN)by dynamic CT enhanced scanning.Methods The clinical data of 100 patients with SPN admitted in our hospital from May 2017 to May 2019 were analyzed retrospectively,included 62 patients with lung cancer,30 patients with pulmonary nodules and 8 patients with pulmonary tuberculosis.All patients underwent dynamic enhanced CT scanning,and the enhanced manifestations of SPN in dynamic contrast-enhanced scan and CT value measurement results of lesions in plain scan and dynamic enhanced scan were analyzed.Results In 62 cases of lung cancer,there were 32 cases of heterogeneous enhancement,29 cases of homogeneous enhancement and 1 case of peripheral enhancement.Among 30 cases of pulmonary nodules,18 cases were enhanced unevenly,and 12 cases were enhanced uniformly.There was no obvious enhancement in 8 cases of pulmonary tuberculosis,after enhancement,the CT value increased<20 Hu.The plain CT value of lung cancer were lower than that of enhanced CT value in each phase,the differences were statistically significant(P<0.05).There was no significant difference in CT value of lung cancer in different phases(P>0.05).The plain CT value of pulmonary nodules were lower than those of the enhanced CT value in each phase,and the differences were statistically significant(P<0.05).The CT value of 30 s enhanced pulmonary nodules were lower than those of 60 s,120 s and 180 s enhanced pulmonary nodules,the difference were statistically significant(P<0.05).There were significant differences in CT value between 60 s,120 s and 180 s of pulmonary nodules enhancement(P<0.05).There were no significant differences in CT value of tuberculoma between the plain scanning and enhanced phases(P>0.05).Conclusion Benign and malignant SPNs have the unique consolidate characteristics of enhanced dynamic CT.The time-density curve within the 30-second enhancement period of the lung cancer is obviously rising,the time-density curve of the pneumonia nodule is gradually rising,and the time-density curve the SPN of tuberculosis is flat.