螺旋CT薄层扫描对肺内孤立小结节的诊断价值  

Diagnostic Value of Thin-Section Spiral CT Scan in Small Solitary Pulmonary Nodules

作　　者：向东 罗天友[1] 吴景全[1] 袁书伟[1] 史斌[1] 吕发金[1] 

机构地区：[1]重庆医科大学附属第一医院放射科,400016

出　　处：《中国医学计算机成像杂志》2006年第3期170-174,共5页Chinese Computed Medical Imaging

摘　　要：目的:评价螺旋CT薄层扫描诊断肺内孤立小结节(sSPN)的价值。材料和方法:收集80例经手术病理证实的直径≤2cmsSPN,其中恶性肿瘤31例,炎性结节及结核结节各20例,良性肿瘤9例,所有病例均行常规及薄层平扫加增强扫描,分析sSPN的CT征象。结果:螺旋CT薄层扫描能显示常规扫描不能显示的部分细小钙化、毛刺征、空泡征、棘状突起及脂肪等,对sSPN有较大鉴别诊断价值的CT征象是毛刺征、分叶征、空泡征、钙化及胸膜凹陷征。增强扫描,恶性sSPN强化明显,多呈均匀强化,增强前后CT净增值大于20Hu;良性sSPN多数强化不明显,增强前后CT净增值小于20Hu(除炎性假瘤及血管瘤外),结核结节及肺囊肿呈环状强化,其余良性结节多呈均匀强化。结论:对于sSPN,螺旋CT薄层扫描比常规扫描能显示更多细微CT征象,是目前最有效的检查方法,有助于sSPN定性诊断。Objective： To evaluate the diagnostic value of thin - section spiral CT scan in small solitary pulmonary nodules （sSPN） . Materials and Methods： There were eighty patients with sSPN less than 2 cm in diameter proved by pathology , including 31 cases of malignant tumor, 20 cases of inflammatory nodules , 20 cases of tuberculous nodules , and 9 cases of benign tumors. Conventional and thin - section CT scans with and without intravenous injection of contrast medium were performed for all cases. The CT signs of sSPN were analyzed. Results： Thin - section spiral CT scan could show fine calcification, thin spiculated sign,vacuole sign, spinous prominence and fat and so on. Conventional CT scan could not show some of these sign. The CT signs which had important differential diagnostic value in sSPN were thin spiculated sign , lobular sign, vacuole sign, calcification and pleural indentation. Most malignant sSPN showed obvious and homogeneous enhancement. The enhanced CT value was more than 20 Hu. Most benign sSPN showed mild enhancement. The enhanced CT value was less than 20 Hu, except inflammatory pseudotumor and hemangioma. Tuberculous nodules and lung cyst showed circular enhancement. Other benign sSPN had mostly homogeneous enhancement.Conclusion： Thin- section spiral CT scan can show more fine CT signs in sSPN and is most available check method and is conducive to distinguish malignant sSPN from benign one.

关 键 词：肺内孤立小结节 CT 诊断 

分 类 号：R816.4[医药卫生—放射医学]