HRCT及螺旋CT增强扫描在周围型小肺癌诊断中的价值

Value of High Resolution CT and Spiral CT Enhanced Scanning in Diagnosis of Small Peripheral Lung Cancer

目的:探讨HRCT及螺旋CT增强扫描在周围型小肺癌诊断中的价值.方法:搜集经手术或穿刺病理证实的周围型小肺癌(直径≤3cm)46例,全部行HRCT扫描,分析其各种CT征象.25例行螺旋CT增强扫描,对病灶强化前后CT值增幅特点进行分析.结果:HRCT表现:①分叶征(91.3%);②毛刺征(87%);③胸膜凹陷征(78.3%);④血管集束征(54.3%);⑤空气支气管征及空泡征(34.8%);⑥棘状突起(32.6%);⑦磨玻璃样密度(10.9%);⑧钙化(8.7%).强化前后CT值增幅20~30HU占16%,30~65HU占76%,＞65HU占8%.结论 :HRCT及螺旋CT增强扫描是周围型小肺癌诊断中重要的检查手段.同时具备3个及其以上CT征象,尤其是前5个征象中2个以上即可确诊,其正确率为91.3%.强化前后CT值增幅在20~65HU之间,对于肺癌诊断更加可靠,正确率达92%.

Objective To evaluate the value of high resolution CT and spiral CT enhanced scanning in diagnosis of small peripheral hung cancer. Methods The authors collected 46 patients with pathologically-proved small peripheral lung cancer (≤3cm in diameter). All cases were scan by high resolution CT. To study the stigmata of all. Spiral CT enhanced scanning was done in 25 patients, Analysis stigmata of the increasing range in CT value in reinforcement anterior and posterio. Results Manifest of high resolution CT scanning:①lobulation sign (91.3%);②spiculatecd sign(87%);③pleural indentation sign (78.3%);④vascularnotch sign (54.3%);⑤sign of air bronchus and vacuole (34.8%);⑥spinose processus (32.65%);⑦milling glass dens (10.9%);⑧calcification (8.7%). The increasing range in CT value in reinforcement anterior and posterio 20~30HU (16%), 30~65HU(76%),>65HU(8%). Conclusion High resolution CT and spiral CT enhanced scanning were important method in the diagnosis of small peripheral lung cancer. The final diagnosis which are of more than 3 sign on CT or above all are 2 sign in anterior 5 sign, precision rate(91.3%). The icereasing range in CT value in reinforcement anterior and posterio 20~30HU, It is terrier reliable in diagnosis of lung cancer, precision rate (92%).