增强后薄层动态CT对孤立性肺结节病变的评价(附45例病例分析)  

Solitary Pulmonary Nodules:The evaluation of Postcontrast Dynamic Thin-sectoin CT(Analysis of 45 cases)

作　　者：邓克学[1] 曹东兴[1] 李世青[1] 

机构地区：[1]安徽省立医院CT室

出　　处：《实用放射学杂志》1999年第3期144-147,共4页Journal of Practical Radiology

摘　　要：目的：定量评价孤立性肺结节病变在增强后薄层动态ＣＴ扫描中的特征表现，探讨其敏感度及特异度。方法：选取直径小于３ｃｍ的孤立性肺结节病变４５例在薄层ＣＴ平扫及增强后２５ｓ，２ｍｉｎ及５ｍｉｎ对病灶感兴趣区进行ＣＴ值的测定，进行统计学分析。结果：４５例病灶在强化上呈三种形式：增强后明显强化（增强前后差值≥４０ＨＵ）称为Ａ型者２５例；增强后扫描时间延至５ｍｉｎ仍未见强化（差值＜１０ＨＵ）为Ｂ型１１例，增强后开始轻微强化，呈逐渐上升趋势（Ｃ型）９例。与术后病理比较：周围型肺癌（２２例）强化方式以Ａ型为主，其敏感度为９１％、特异度为７８％。结核球（１４例）以Ｂ型强化方式为主，其敏感度为７１％，特异度为８８％。炎性假瘤（４例）以Ａ、Ｃ型为主，血管瘤（２例）以Ｃ型为主，畸胎瘤（３例）Ａ、Ｂ、Ｃ型均有。结论：孤立性肺结节病变以周围型肺癌及结核球为多见，薄层动态ＣＴ扫描强化方式表现不同。Objective:To quantitatively evaluate the sensitivity and specificity of solitary pulmonary nodular lesions(SPN) on postcontrast dynamic thin-section CT.Methods:The SPN lesions which were smaller than 3 cm in diameters were evaluated in 45 patients comfimd by operation and pathology,CT values of the inner area of the nodule (ROI)on plain CT and on contrast-enhanced CT at 25 seonds,2 minutes,and 5 minutes after administration of contrast media were respectively measured,then the statistical analysis was done.Results:the lesions enhancement patterns were classified into 3 types:Type A which had marked enhancement (the difference between pre-and postcontrast was 40 HU)was 25 cases,Type B which had no enhancement even delayed to 5 minutes (<10 HU)was 11 cases,type C which had slight enhancement at 25 seconds and then gradually increased was 9 cases.The enhanced pattern of peripheral lung carcinomas(22 cases)was mainly type A,It′s sensitivity was 91%,specificity was 78%.Tuberculoma(14 cases)was mainly type B,the sensitivety was 71% and the specificity was 88%.Other lesions had no significance.Conclusion:Both peripheral lung carcinoma and tuberculoma are the most common lesions in SPN.The different enhanced patterns on contrast enhanced dynamic thin-section CT can improve the correct diagnosis.

关 键 词：孤立性 肺结节病变 CT 定性诊断 

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