孤立性肺恶性结节与炎性结节螺旋CT三维成像研究  

Solitary pulmonary malignant and inflammatory nodules:study with three-dimensional reconstruction CT

作　　者：韩丹[1] 何茜[1] 宋光义[1] 

机构地区：[1]昆明医学院第一附属医院CT室,云南昆明650032

出　　处：《云南医药》2005年第3期196-199,共4页Medicine and Pharmacy of Yunnan

摘　　要：目的探讨4层螺旋CT三维容积重建成像对孤立性肺恶性与炎性结节的诊断和鉴别诊断价值。方法对33例孤立性肺结节(SolitarypulmonaryNoduleSPN)(≤4cm)进行研究,于注射对比剂1.5mlkg前及注射后30sec,对病灶进行薄层扫描,并对增强图像行三维容积重建(three-dimensionalvolumerendering3DVR)。分析结节的三维立体形态及邻近结构改变。经病理证实14例恶性结节、2例炎性结节及经临床抗炎治疗后完全吸收的炎性结节6例,共22例纳入本研究。结果(1)形态:恶性结节主要为分叶型,炎性结节主要为棘突型;(2)邻近结构改变:胸膜凹陷主要见于恶性结节,而炎性结节与胸膜呈广基相连;可见肺血管与结节相连。结论肺恶性及炎性结节三维成像,两者的形态及邻近改变有各自的特点;4层螺旋CT三维容积重建对肺恶性及炎性结节的鉴别有一定价值。Objective To discuss the value of distinguishing pulmonary inflammatory nodules from malignant ones using multi-slice spiral CT(MSCT)three dimensional volume rendering (3DVR).Method 33 cases of solitary pulmonary nodules(SPNs)(diameters≤4cm)were involved.Before and after injection of 1.5ml/kg iodinated contrast material,thin-section CT scans were performed,and the enhancement data was reconstructed using 3DVR.The nodules' 3D surface morphology and neighbor structures were interpreted.14 cases of malignant nodules and 2 cases of inflammatory nodules pathologically proved,and 6 cases of inflammatory nodules healed,were included in this study.Results Three-dimensional reconstruction images,(1) 3D surface morphology:Malignant nodules showed lobulated pattern,inflammatory ones showed spiculate protuberance pattern;(2)Neighbour changes:Pleural indentation were mainly seen in malignant nodules,while inflammatory nodules adhered with pleurae in extensive base.The linking between vessels with SPN were seen in all nodules.Conclusion 3D images show difference features of malignant and inflammatory SPNs.3D reconstruction images are helpful to distinguish inflammatory nodules from malignant ones.

关 键 词：肺 三维容积重建 孤立结节 

分 类 号：R733.7[医药卫生—肿瘤]