16层螺旋CT对肺内结节性病变的动态增强研究  

Dynamic enhanced scanning of the pulmonary nodules with 16-slice spiral CT

作　　者：李新瑜[1] 张雪林[1] 张玉忠[1] 陈斌[1] 王建平[1] 石珍[1] 

机构地区：[1]南方医科大学南方医院影像中心,广东广州510515

出　　处：《南方医科大学学报》2009年第1期133-136,共4页Journal of Southern Medical University

摘　　要：目的探讨16层螺旋CT动态增强扫描对肺内结节性病变的定性诊断价值。方法69例患者行动态增强扫描,对确诊的53例(恶性组34例,良性组13例,活动性炎性组6例)进行分析,比较T-DC(时间-密度曲线)及相应的参数值。结果强化增值及S/A比值3组间差异显著(P<0.001),均以炎性结节最高,恶性结节次之,良性结节相对最低,组间两两比较差异亦均有统计学意义(均P<0.05)。以强化增值≥25Hu或S/A>10%作为诊断为恶性病变的阈值,可以得到相对较高的阴性预测价值和准确度,3组结节增强后期末次扫描消退值差别亦有统计学意义(P<0.05),综合增强早期和后期的组织密度变化特点,即以强化增值≥25Hu且0Hu≤消退值<35Hu作为鉴别良恶性的界值,可使单用强化增值作为诊断标准的假阳性率从57.89%降至47.37%。结论利用16层螺旋CT及其配置的灌注分析软件对肺结节进行动态增强研究,方便快捷,有助于肺结节的鉴别诊断。Objective To assess the value of dynamic enhanced CT scanning in diagnosis of pulmonary nodules. Methods Sixty-nine patients with pulmonary nodules underwent examination with dynamic enhanced CT scanning. Of these patients, 53 with definite diagnoses confirmed by histological or clinical data were divided into three groups according to the nature of the nodules, namely the malignant group （n=34）, benign group （n=13） and active inflammatory group （n=6）. The time-density curve （T-DC） and the corresponding parameters of these patients were compared. Results Significant differences in the net enhancement and S/A ratio were found among the 3 groups （P〈0.001）. The active inflammatory nodules showed the highest enhancement, followed by malignant nodules and then by benign nodules, with significant differences between any of the two groups （P〈0.05）. At the diagnostic threshold of net enhancement by 25 Hu or S/A ratio by 10% for malignant nodules, a higher negative predictive value and accuracy were obtained. The difference in the wash-out value among the 3 groups was statistically significant （P〈0.05）. When diagnostic criteria for malignancy was defined by a wash-in value of 25 Hu or higher and wash-out value of 0-35 Hu, the false-positive rate was decreased from 57.89% to 47.37%. Conclusion The application of 16-slice spiral CT and its CT perfusion software allows convenient dynamic enhancement study of pulmonary nodules and can be helpful in their differential diagnosis.

关 键 词：多层螺旋CT 动态增强 肺结节 

分 类 号：R816.4[医药卫生—放射医学]