肺部肿块的CT分期动态增强扫描方法研究  

The research of pulmonary masses with different-phase dynamic enhanced multi-slice CT

作　　者：杨利莉[1] 张志远[1] 

机构地区：[1]宁夏医学院附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2008年第4期309-311,共3页Ningxia Medical Journal

基　　金：宁夏自治区卫生厅重点科研项目(W200749)

摘　　要：目的探讨分期动态增强扫描对肺部肿块的诊断价值。方法选择经胸部平片或CT平扫证实存在肺部肿块的病例52例行分期动态CT增强研究,其中经病理及临床证实的周围型肺癌38例,其他各种良性病变14例。先进行对比剂预注射扫描,测得肺动脉和主动脉增强峰值时间以确定肺动脉和主动脉的扫描时间,延迟时间至5分钟。测量肿块增强前后各时期的CT净增值并分析其差异,观察分析各时相内病灶血管的显示情况。结果肺动脉期与主动脉期及各延时期CT净增值比较均具有显著性差异(P<0.01);以肺动脉期CT净增值<25HU,主动脉期≥25HU作为诊断肺癌的标准。行多期增强扫描后肺癌的定性准确率由三期增强扫描的72.7%增加到96.3%,准确率提高了23.6%。结论(1)多期CT增强扫描对肺部肿块的鉴别诊断价值较大;(2)准确设定肺动脉期和主动脉期扫描时间点,有助于肿瘤血管的观察;(3)多期增强扫描中延迟时间的选择以5分钟为宜;(4)肿块CT值的测量应以肿块强化明显区域为主,并多点测量,各期测量的位置和大小要求严格一致;(5)主动脉期内进行全胸扫描有助于对淋巴结的观察。Objective To evaluate the value of Different -phase dynamic enhanced multi -slice CT （MSCT） in the diagnosis of pulmonary nodules （masses）. Methods The dynamic enhanced CT with pulmonary nodules （masses） were performed in 52 cases, 38 cases verified to be lung cancer and 14 cases verified to be benign lesion by pathology and clinics. The peak densitytime of pulmonary artery and aorta was used as the delayed time for pulmonary phase and aortic phase and the delayed time was from 1 to 5 minutes. The net elevation of the CT value of nodules in CT without enhancement as well as that in different-phase enhanced technique were measured, and also the tumor vessels were studied. Results Statistically difference of the CT value were found between pulmonary phase and other phases （ P 〈 0.01 ） The net increased CT value were statistically significant respectively between pulmonary phase and other phases （ P 〈0.01 ） ; When net increased CT value 25 HU in aortal phase while net increased CT value 25 HU in pulmonary phase was set as a diagnostic threshold, The diagnostic accuracy of lung cancer from 72.7% to 96.3% by different-phase enhanced MSCT and it raised 23.6%. Conclusion （ 1 ） Different-phase enhanced MSCT is very valuable to both diagnosis and distinguish diagnosis of pulmonary nodules （masses） ; （2） It is very useful to study the tumor vessels if the delayed time for pulmonary phase and aortic phase were set exactly; （3） It is good that the delayed time was selected in 5 minutes; （4） To select the obviously enhanced region to measure the CT value and measure more times, the location and size of ROI must identical （5） It is helpful to observe lymphoid node by scanning the whole thoracic in the aortic phase.

关 键 词：肺癌 体层摄影术 X线计算机 动态CT增强 

分 类 号：R816.4[医药卫生—放射医学]