多层螺旋CT多平面重组对孤立性肺结节征象检出的价值  

Demonstration of Signs in Solitary Pulmonary Nodules by MSCT Multi-planar Reformation

作　　者：蒋南川[1] 韩萍[1] 周承凯[1] 郑金龙[1] 史河水[1] 雷子乔[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《放射学实践》2007年第12期1289-1292,共4页Radiologic Practice

摘　　要：目的:比较多层螺旋CT多平面重组(MPR)对孤立性肺结节(SPNs)征象的显示,探讨各种征象对SPNs良恶性的诊断价值。方法:搜集51例进行多层螺旋CT扫描的SPNs(直径≤4cm)及其完整的临床病理资料。对SPNs的征象(深分叶征、棘状突起征、胸膜凹陷征、胸膜切迹征、阳性支气管征、空泡征、毛刺征)行MPR,评价MPR对SPNs的前5种征象的显示。计算7种征象在恶性结节组检出率及出现频率。结果:MPR检出5种征象的数目明显多于轴面扫描所检出的数目,检出具有5种征象的结节数目明显多于轴面扫描检出该征象的结节数目,差异具有显著性意义(P<0.05)。在恶性结节中出现频率由多到少的征象依次为深分叶征、阳性支气管征、胸膜凹陷征、棘状突起征、胸膜切迹征、毛刺征、空泡征。7种征象在良、恶性结节组的检出百分比中最能提示恶性的征象依次为胸膜切迹征、深分叶征、胸膜凹陷征、毛刺征、阳性支气管征、棘状突起征、空泡征。结论:应用多层螺旋CT薄层扫描,对SPNs行MPR,能明显提高SPNs的征象检出率,获得更多有价值的诊断信息,深分叶征、胸膜切迹征是最有诊断价值的恶性征象。Objective.. To compare the demonstrations of sighs in solitary pulmonary nodules by MPR and to evaluate the potential role of these signs in the diagnosis of benign and malignant nodules. Methods： 51 cases of SPNs （diameter 4cm） confirmed by pathology and clinic underwent MSCT scans. MPR was applied to demonstrate the signs. Then the displays of 5 signs （deep lobulation, spinous protuberance, pleural indentation, nodule notch due to pleural indentation, the positive bronchus sign） were evaluated by MPR. The detection rate and frequency of 7 signs （5 signs,vacuole sign,speculation） were counted in malignant nodules. Results：On MPR images,the number of 5 signs was greater than that on CT axial images. On MPR images,the number of SPNs with 5 signs was greater than that on CT axial images, the difference was significant. The occurrence of signs in malignant nodules was as follows：deep lobulation, the positive bronchus sign, pleural indentation, spinous protuberance, nodule notch due to pleural indentation, speculation, and vacuole sign. The potential role of 7 signs detection in malignant nodules was as follows：nodule notch due to pleural indentation,deep lobulation, pleural in- dentation,speculation, the positive bronchus sign, spinous protuberance, and vacuole sign. Conclusion： MPR in thin-slice MSCT Scans significantly improves detection rate of signs in SPNs. Deep lobulation and nodule notch due to pleural indentation accurately demonstrate the malignacy.

关 键 词：肺肿瘤 肺结节 孤立性 体层摄影术 X线计算机 图像处理 计算机辅助 

分 类 号：R816.4[医药卫生—放射医学]