高分辨螺旋CT增强扫描诊断肺内孤立小结节

The High Resolution Enhanced Spiral CT in the Diagnosis of Pulmonary Solitary Nodules

目的 :评价高分辨螺旋CT增强扫描诊断肺内孤立小结节的价值。材料和方法 :直径小于 3cm的肺内孤立小结节患者 40例 ,其中周围性肺癌 2 9例 ,转移瘤 1例 ,肺炎性肿块 5例 ,结核瘤 2例 ,肺错构瘤、肺囊肿及肺血管瘤各 1例。40例患者先行常规CT扫描 ,发现病变后局部行高分辨螺旋CT扫描 ,仍不能定性诊断时行高分辨螺旋CT增强扫描。 40例病例均行前瞻性对比研究。结果 :高分辨螺旋CT增强扫描诊断肺内孤立性小结节的正确率为 81% ,肺内恶性结节大多均匀增强且增强CT值大于 2 0Hu ,平均增强CT值为 3 6Hu。良性结节多周边增强且增强CT值小于 10Hu。结论 :高分辨螺旋CT增强扫描有助于肺内孤立性小结节定性诊断 ,同时强调必须结合病变的基本形态特征综合考虑。

Purpose: To evaluate the diagnostic value of high resolution enhanced spiral CT in small pulmonary solitary nodules(SPNs). Materials and Methods: The plain, spiral and contrast enhanced CT date of 40 patients with SPNs less than 3cm in diameter confirmed by pathology were retrospectively studied, among which 29 cases presented with peripheral lung cancers, 1 with metastatic tumor,5 with inflammatory masses of the lung, 2 with nodular tuberculomas, 1 with hamartoma, 1 with hemangioma and 1 with lung cyst. Results: The accurate rate of high resolution enhanced spiral CT for diagnosis of SPNs was 81%. The mean value of enhanced CT with malignant SPNs and benign ones were 36Hu and 9Hu respectively. Most malignant SPNs showed homogeneous enhancement, The enhanced CT value was more than 20Hu. The benign ones were heterogeneous enhancement, The enhanced CT value was less than 10Hu. Conclusion: High resolution enhanced spiral CT examination makes it possible to distinguish malignant SPNs from benign ones in most situations. In the same time, we emphasize that the features of imaging mophology of SPNs, have important value in differentiating malignant SPNs from benign ones.