螺旋CT对肺结节生长变化的观察及良恶性的诊断

Spiral CT Diagnostic Value in Assessing Growth and Malignancy Status of Pulmonary Nodule

目的 :探讨螺旋CT在观察肺结节生长变化及良恶性判断中的价值。方法 :19例有完整病例资料的肺内结节接受薄层螺旋CT扫描 ,测量结节 2D直径和面积及 3D容积 ,通过计算结节倍增时间来预测其良恶性 ,预测结果与最终病理结果或追踪 2年以上结果比较。结果 :按肺癌标准生长模式 ,恶性结节 4周后直径和面积分别增大超过 3%和 7% ,容积增大超过 11% ;肺内结节 2D预测结果 74 % (14 19)与最终结果一致 ,3D容积预测结果 10 0 % (19 19)与最终结果一致 ,3D结果优于 2D结果 ,P <0 .0 5。结论 :螺旋CT 2D和 3D测量技术能很好地观察肺结节的生长变化 ,倍增时间能准确反映结节性质 ,3D容积测量更为准确 ;肺结节尤其是直径小于 2 4mm者CT短期复查 (4周内 )

Objective: To determine the accuracy of Spiral tomographic (SCT) measurements of small pulmonary nodules to assess growth and malignancy status. Methods: SCT measurement techniques were including nodule diameter,area and volume was used to assess 19 pulmonary nodules (12 malignant, 7 benign) in patients who underwent repeat SCT as part of their routine clinical protocol, and the final diagnoses were established with surgical resection biopsies or follow ups more than 2 years. Results: With use of standard exponential growth curves and known tumor growth rates, malignant growth could be detected in within 4 weeks, nodule diameter,area or volumetric increase was more than 3%,7% or 11% respectively; 14/19 in vivo nodules were correctly classified with 2D measurements of diameter(13/19) and area(14/19); 19/19 nodules were correctly classified with volumetric measurements, volumetric result was more accurate, P<0.05. Conclusion: SCT has highly accuracy in growth measurements of pulmonary nodules, and volumetric measurement is better for determining volume and is useful in assessing growth of small nodule and calculating its doubling time. Early repeat SCT could find the changes of malignant nodules.