动态CT对肺内孤立性结节诊断价值的探讨  

The Evaluation of Solitary Pulmonary Nodule with Incremental Dynamic CT

作　　者：王春泉 朱珊珊[1,2] 邱运荣 

机构地区：[1]广州市第六人民医院CT室 [2]江西医学院第二附属医院CT室

出　　处：《实用放射学杂志》1999年第4期224-227,共4页Journal of Practical Radiology

摘　　要：目的：探讨动态ＣＴ对肺内孤立性结节的诊断价值。方法：３５例直径６～４０ｍｍ的肺内孤立性结节，其中１９例肺癌，１２例结核球，２例炎性肉芽肿，２例错构瘤。对肺内孤立性结节进行薄层平扫后，以１．５ｍｌ／ｓ肘静脉注射碘对比剂后３０ｓ、２ｍｉｎ及５ｍｉｎ于相同二个中心层面进行动态增强扫描，计算结节最大强化ＣＴ值，描绘结节的时间—密度曲线，分析结节的强化类型。结果：全部肺癌和炎性肉芽肿显著增强，结核球无明显增强（Ｐ＜０．０１）。肺癌的时间—密度曲线表现逐渐升高，且大多数肺癌强化的峰值在注射对比剂后５ｍｉｎ，与良性结节明显不同。全部肺癌、错构瘤、结核球和炎性肉芽肿各例表现完全强化型，１例错构瘤和６例结核球表现无强化型，５例结核球表现边缘环状强化型，１例炎性肉芽肿表现周围强化型。结论：最大强化ＣＴ值＞２０ＨＵ的结节提示肺癌和少数活动性良性结节，无强化和／或边缘环状强化的结节提示结核球。Objective: To evaluate the diagnostic value of solitary pulmonary nodules(SPN) with incremental dynamic CT. Methods: Thirty-five adult patients with SPN (6～40 mm-diameter)were analyzed,including 19 primary lung cancers,12 tuberculomas,2 granuloms,and 2 hamartomas.Serial thin-section CT scans were performed before and 30 seconds,2 minutes and 5 minutes after administration of iodinated contrast material at 1.5 ml/sec.The CT numbers of the inner area of the nodule before and after adminstration and the maximum level of enhancement were recorded.The time-attenuation curves of the nodule were obtained.The enhancement patterns of the nodules were analyzed. Results: All lung cancers and two granulomas showed significantly greater enhancement(p<0.01) than eleven of twelve tuberculomas,which did not show enhancement.The time-attenuation curve of lung cancers was significatly different from that of benign nodules.The time-attenuation curve of lung cancers showed gradual enhancement and most of the lung cancers reached peak enhancement 5 minutes after administration of contrast material.All lung cancers(1 hamartoma, 1 tuberculoma and 1 granuloma)showed complete enhancement,1 hamartoma and 6 tuberculomas showed no enhancement.5 tuberculomas showed capuslar enhancement.1 granuloma showed peripheral enhancement. Conclusion: Lung cancers and few active benign SPNS have the maximum level of enhancement (>20 HU).No enhancement and/or capsular enhancement of SPNS is suggested as tuberculomas.

关 键 词：肺肿瘤 肺内孤立性结节 诊断 CT 

分 类 号：R734.204[医药卫生—肿瘤] R730.44[医药卫生—临床医学]