目的探讨多层螺旋CT动态增强成像技术在肺部孤立性结节(SPN)良恶性鉴别诊断中的应用价值。方法采用回顾性研究方法,选取2017年1月至2019年12月连云港市第二人民医院收治的SPN患者70例,将患者CT常规扫描与动态增强扫描的结果进行分析,以...目的探讨多层螺旋CT动态增强成像技术在肺部孤立性结节(SPN)良恶性鉴别诊断中的应用价值。方法采用回顾性研究方法,选取2017年1月至2019年12月连云港市第二人民医院收治的SPN患者70例,将患者CT常规扫描与动态增强扫描的结果进行分析,以病理穿刺诊断结果为金标准,分析CT动态增强扫描的诊断结果,对比常规与动态增强扫描的CT值变化。结果 SPN在病理穿刺诊断结果中,良性46例,恶性24例。SPN在CT动态增强扫描中,良性43例,恶性27例,与病理穿刺诊断比较,误诊率与漏诊率差异均无统计学意义(P> 0.05)。CT动态增强扫描的敏感度为93.02%,特异度为77.78%,阳性预测值为86.96%,诊断符合率为87.14%。恶性SPN的常规扫描(25.52±11.39 Hu vs.13.24±5.79 Hu)与动态增强扫描CT值(79.38±7.68 Hu vs.17.49±5.63 Hu)均明显高于良性SPN,良性与恶性SPN动态增强扫描CT值改变幅度明显大于常规扫描,差异均具有统计学意义(P <0.05)。结论多层螺旋CT动态增强成像技术能够准确鉴别诊断SPN的良恶性。展开更多
BACKGROUND It now seems that all pulmonary hamartomas(PHs)are large cystic-solid lesions that are difficult to diagnose.However,few cases of large cystic-solid PHs have been reported.The present case report presents a...BACKGROUND It now seems that all pulmonary hamartomas(PHs)are large cystic-solid lesions that are difficult to diagnose.However,few cases of large cystic-solid PHs have been reported.The present case report presents a large cystic-solid PH and provides a literature review of the imaging features,formation mechanism and histopathological basis of PHs.CASE SUMMARY A 53-year-old woman with no clinical symptoms underwent a chest computed tomography(CT)examination at our hospital.Nonenhanced CT images revealed a large,flat tumor with multiple air-containing cysts in the left thoracic cavity and a cystic part confined to the medial side of the tumor;the solid part of the tumor showed abundant fat and lamellar soft tissue components.Multiple small blood vessels were detected in the solid part of the tumor on contrast-enhanced CT images.Given the large size of the lesion,the patient elected to undergo surgery.Histological examination revealed PH.A detailed review of the patient’s CT imaging showed that the lesion had a small vascular pedicle to the left lower lobe,which was a clue to its lung tissue histological origin.According to immunohistochemical staining,the confined multiple air-containing cysts were caused by the entrapment of respiratory/alveolar epithelium.CONCLUSION This case shows the imaging manifestations of a large PH.Heightened awareness of its formation mechanism and histopathological basis may alert radiologists to consider this diagnosis in their daily workflow.展开更多
文摘目的探讨多层螺旋CT动态增强成像技术在肺部孤立性结节(SPN)良恶性鉴别诊断中的应用价值。方法采用回顾性研究方法,选取2017年1月至2019年12月连云港市第二人民医院收治的SPN患者70例,将患者CT常规扫描与动态增强扫描的结果进行分析,以病理穿刺诊断结果为金标准,分析CT动态增强扫描的诊断结果,对比常规与动态增强扫描的CT值变化。结果 SPN在病理穿刺诊断结果中,良性46例,恶性24例。SPN在CT动态增强扫描中,良性43例,恶性27例,与病理穿刺诊断比较,误诊率与漏诊率差异均无统计学意义(P> 0.05)。CT动态增强扫描的敏感度为93.02%,特异度为77.78%,阳性预测值为86.96%,诊断符合率为87.14%。恶性SPN的常规扫描(25.52±11.39 Hu vs.13.24±5.79 Hu)与动态增强扫描CT值(79.38±7.68 Hu vs.17.49±5.63 Hu)均明显高于良性SPN,良性与恶性SPN动态增强扫描CT值改变幅度明显大于常规扫描,差异均具有统计学意义(P <0.05)。结论多层螺旋CT动态增强成像技术能够准确鉴别诊断SPN的良恶性。
文摘BACKGROUND It now seems that all pulmonary hamartomas(PHs)are large cystic-solid lesions that are difficult to diagnose.However,few cases of large cystic-solid PHs have been reported.The present case report presents a large cystic-solid PH and provides a literature review of the imaging features,formation mechanism and histopathological basis of PHs.CASE SUMMARY A 53-year-old woman with no clinical symptoms underwent a chest computed tomography(CT)examination at our hospital.Nonenhanced CT images revealed a large,flat tumor with multiple air-containing cysts in the left thoracic cavity and a cystic part confined to the medial side of the tumor;the solid part of the tumor showed abundant fat and lamellar soft tissue components.Multiple small blood vessels were detected in the solid part of the tumor on contrast-enhanced CT images.Given the large size of the lesion,the patient elected to undergo surgery.Histological examination revealed PH.A detailed review of the patient’s CT imaging showed that the lesion had a small vascular pedicle to the left lower lobe,which was a clue to its lung tissue histological origin.According to immunohistochemical staining,the confined multiple air-containing cysts were caused by the entrapment of respiratory/alveolar epithelium.CONCLUSION This case shows the imaging manifestations of a large PH.Heightened awareness of its formation mechanism and histopathological basis may alert radiologists to consider this diagnosis in their daily workflow.
