螺旋CT对肺孤立性结节定性诊断的评价  

The applying study of the differentiated diagnosis in solitary pulmonary nodules with spiral computed tomography

作　　者：王利伟[1] 王自正[1] 顾建平[1] 冯敏[1] 张林[1] 周星帆[1] 

机构地区：[1]南京医科大学附属南京第一医院,江苏南京210006

出　　处：《四川医学》2007年第4期349-351,共3页Sichuan Medical Journal

基　　金：江苏省社会发展科技基金项目(BS2004507)

摘　　要：目的 进一步评价螺旋CT在肺孤立性结节（SPN）定性诊断中的应用价值，提高肺肿瘤诊断的准确性。方法 54例SPN患者行CT检查，男28例，女26例，年龄25—84岁。常规扫描后进行薄层扫描，薄层平扫和增强扫描的层厚为3mm，螺距1．0。分析CT平扫和增强的影像学表现，并与病理结果对照。结果 肺癌和炎性假瘤增强后表现为均匀或不均匀斑片状强化，结核球无强化或边缘强化。依据平扫征象诊断恶性SPN的敏感度、特异度分别为92％、53％。以净强化值〉20HU为界值，依据增强表现诊断恶性SPN的敏感度、特异度分别为96％、57％。结论 依据CT平扫特征及增强表现，结合病史可以对SPN的良恶性做出基本准确的诊断。Objective To estimate the value of spiral CT in the diagnosis of solitary pulmonary nodules（SPN） and to improve the right diagnosis rate before surgery. Methods This study includes 54 patients with SPN confirmed by pathology,28 male and 26 female, aged from 25 to 84.Unenhanced CT and enhanced CT scanning were performed in all patients. After routine scanning,thin scanning and enhanced scanning were done with slice thickness 3mm and pitch 1.0. The characteristics of unenhanced CT and enhanced CT were analyzed. Results The density of SPN scanned with unenhanced thin section was even.The Lung cancers and inflammatory pseudotumors revealed significantly even or uneven enhancement. Tuberculomas showed no or brim enhancement. The sensitivity and the specificity of lung cancer diagnosed with unenhanced thin section CT were 92% and 53% .With 20HU or more of net enhancement as a cutoff value in differentiation of malignant and benign nodules, sensitivity for malignant nodules was 96 %, specificity 57 %. Conclusion With consideration of the case history, the valuable diagnosis may be made for SPN on the basis of the signs of unenhanced and enhanced thin section CT.

关 键 词：肺肿瘤 体层摄影术 X线计算机 

分 类 号：R816.4[医药卫生—放射医学]