不同病理类型肺癌患者孤立性肺结节64排螺旋CT动态增强扫描特点分析

Dynamic contrast-enhanced 64-slice spiral CT scanning in patients with different pathological types of lung cancer

目的探究64排螺旋CT动态增强扫描针对不同病理类型肺癌患者孤立性肺结节扫描特点,分析其临床应用价值。方法课题纳入对象为笔者单位影像科于2017年12月到2019年11月收治的肺癌患者,共计90例,均伴有孤立性结节,结节直径≤30 mm,均予以患者64排螺旋CT动态增强扫描。结果三种病理类型肺癌CT值随着检验时间延长,数值升高到峰值后下降,于90~180s期为峰值阶段,腺癌结节峰值期略早于其他两种病理类型,腺癌于峰值后CT值下降趋势较缓,CT数值比对其他两种病理类型差异统计校验表意义(P<0.05);小细胞癌孤立性结节其强化率及净增值情况显著低于其他两种病理类型,差异统计校验表意义(P<0.05);腺癌患者孤立性肺结节均匀强化比重为86.67%,高于鳞癌均匀强化比值(68.18%)及小细胞癌均匀强化比值(50.0%),差异无统计学意义(P>0.05)。结论不同病理类型肺癌患者其孤立性肺结节于CT动态增强扫描存在一定差异性,可将螺旋CT动态增强扫描作为病理类型鉴别诊断手段。

Objective:To explore the characteristics of 64 slice spiral CT dynamic enhancement scanning for solitary pulmonary nodules in patients with different pathological types of lung cancer,and to analyze its clinical application value.Methods:A total of 90 patients with lung cancer admitted to the imaging department of the author's unit from December 2017 to November 2019 were included in the study,all of whom were accompanied by solitary nodules with diameter≤30mm.All patients were given 64-slice dynamic enhanced CT scan.Results:In the three kinds of pathological types of lung,CT value extended along with the test time and fell after the rise of numerical values to peak in the 90~180 s period for peak stage,adenocarcinoma nodules peaked slightly earlier than the other two types of pathology,adenocarcinoma in CT after peak value declined slower,CT value showed more significant difference(P<0.05)than the other two kinds of pathological types;The enhancement rate and net appreciation of solitary nodules in small cell carcinoma were significantly lower than those of the other two pathological types,and the difference was statistically significant(P<0.05).The proportion of uniform enhancement of isolated lung nodules in adenocarcinoma patients was 86.67%,which was higher than the ratio of uniform enhancement of squamous cell carcinoma(68.18%)and small cell carcinoma(50.0%),and the difference was not statistically significant(P>0.05).Conclusion:The solitary pulmonary nodules in patients with different pathological types of lung cancer have certain differences in the dynamic enhanced CT scan.