肺部孤立结节的CT鉴别

Differential diagnosis of solitary pulmonary nodule

目的 :研究肺部孤立结节的CT鉴别。方法 :分析经病理诊断的63例肺部孤立结节的CT表现 ,本组病例经过螺旋CT平扫和增强扫描。重点对病灶的内部结构、边缘形态及增强程度进行总结。结果 :63例中 ,恶性病灶 (肺癌 )30例 ,良性病灶33例。恶性病灶边界清晰 ,多为不规则形 (76.7 % ) ,较多出现空泡征 (56.7 % )、支气管充气征 (40 % )和沙砾状钙化 (26.7 % )、毛刺 (90 % )、棘状突起 (70 % )与血管集束征 (63.3 % )、胸膜凹陷征 (36.7 % )、中～重度强化等 ;而良性病灶大多边缘光滑 (95 % ) ,呈类圆形(75.8 % ) ,较多出现同心圆状、爆米花样或包膜下钙化 (57.6 % ) ,充血征 (57.6 % )、轻～中度强化等。结论 :肺部孤立结节具有较明显的CT特征 ,综合分析各种表现 ,绝大多数病例可做出正确诊断。

Objective:To evaluate the differential diagnosis of solitary pulmonary nodule(SPN).Methods:CTfeatures in63cases of SPNs confirmed by pathology were analyzed.Spiral CTincluding plain scans and contrast enhanced scans were performed in all patients.The internal texture,edge signs and enhance degree were studied.Results:Of all63cases,there were malignant nodules in30cases and benign nodules in33cases.In malignant lesions,clear edges appeared,mostly irregular(76.7%),and were often accompanied with the sign of small bubbles(56.7%),air bronchus(40%),grit calcification(26.7%),burr sign(90%),thorn salience(70%)and blood vessel bundle(63.3%)and hollowed pleura(36.7%).Enhance degrees were moderate to severe while benign lesions were round-shaped(75.8%)and the edges were smooth(95%),often appeared concentric or popcom or under the envelope calcification(57.6%),sign of hyperaemia(57.6%).Enhance de-grees were mild to moderate.Conclusion:SPNs present characteristic CTfeatures,comprehensive analysis can establish accurate diagnosis in most cases.