肺癌孤立性肺结节患者64排螺旋CT扫描影像特点分析

Analysis of 64-slice spiral CT imaging features of solitary pulmonary nodules in patients with lung cancer

目的研究64排螺旋CT对肺癌孤立性肺结节(SPN)的诊断价值。方法选择2015年5月至2019年5月于我院收治的158例经病理证实伴SPN的肺癌患者为对象,按肺癌不同病理类型分为A组(腺癌,112例)、B组(鳞癌,34例)、C组(小细胞癌,12例),均接受64排螺旋CT扫描。比较三组SPN平扫及增强各序列(增强30、60、90、120、180、300、600 s)CT值变化情况,分析三组SPN强化方式、强化净增值、强化率,并对比三组SPN动态增强峰值出现后各延迟扫描时点(180、300、600 s)相对廓清值、廓清率变化情况。结果三组随着扫描时间的延长,SPN CT值先升高后明显降低,增强60~180 s时出现峰值。A组增强30~90 s时SPN CT值显著高于B、C组(P<0.05),且A、B组增强120~600 s时SPN CT值显著低于C组(P<0.05);C组增强60~180 s时SPN CT值显著低于A、B组(P<0.05)。A、B、C组SPN不均匀强化率分别为25.0%、64.7%、50.0%,均匀强化率分别为75.0%、35.2%、50.0%,其中A、B组SPN强化方式比较差异有统计学意义(P<0.05)。A、B组SPN强化净增值均显著高于C组(P<0.05);三组SPN强化率比较差异无统计学意义(P>0.05)。A、B组动态增强峰值出现后SPN延迟扫描180 s时相对廓清值、廓清率均显著高于C组(P<0.05);三组SPN延迟扫描300 s时相对廓清值、廓清率比较差异均无统计学意义(P>0.05);B、C组SPN延迟扫描600 s时相对廓清值、廓清率均显著高于A组(P<0.05)。结论64排螺旋CT能观察不同病理类型肺癌患者SPN影像学特点,在SPN定性诊断方面具有重要意义。

Objective To study the diagnostic value of 64-slice spiral CT in solitary pulmonary nodules(SPN)of lung cancer.Methods From May 2015 to May 2019,158 lung cancer patients with SPN confirmed by pathology were enrolled in our hospital.According to different pathological types of lung cancer,they were divided into group A(adenocarcinoma,112 cases),group B(squamous cell carcinoma,34 cases),and group C(small cell carcinoma,12 cases).All patients underwent 64-slice spiral CT scanning.The changes of CT values of three groups of SPN plain scanning and enhancement sequences(enhancement 30,60,90,120,180,300,600 s)were compared,and the enhancement methods,enhancement net value and enhancement rate of the three groups were analyzed,and the relative clearance values and clearance rates of each delayed scanning point(180,300,600s)after the emergence of dynamic enhancement peak of SPN were compared.Results With the prolongation of scanning time,the SPN CT values of the three groups increased first and then decreased significantly,and peaked at 60-180 s.The SPN CT value of group A was significantly higher than that of group B and C(P<0.05),and the SPN CT value of group A and B was significantly lower than that of group C(P<0.05);The value of SPN CT in group C was significantly lower than that in group A and B(P<0.05).The non-uniform enhancement rates of SPN in group A,B and C were 25.0%,64.7%and 50.0%,respectively,and the uniform enhancement rates were 75.0%,35.2%and 50.0%,respectively,among which the difference of SPN enhancement methods in group A and B was statistically significant(P<0.05).Relative clearance value and clearance rate of SPN delayed scanning 180 s after peak dynamic enhancement in group A and B were significantly higher than those in group C(P<0.05);There was no significant difference in the relative clearance value and clearance rate of three groups of SPN delayed scanning for 300 seconds(P>0.05);The relative clearance value and clearance rate of SPN in group B and C were significantly higher than those in group A(P<0.05).Conclusion 64-slice spiral CT can observe the SPN imaging characteristics of lung cancer patients with different pathological types,which is of great significance in the qualitative diagnosis of SPN.