孤立性肺结节的CT诊断  

CT diagnosis of solitary pulmonary nodules

作　　者：李唯[1] 杨州[1] 杨欣[1] 窦勇[2] 

机构地区：[1]山西医科大学第一医院放射科,山西太原030001 [2]山西省心血管疾病医院CT室

出　　处：《实用医学影像杂志》2011年第3期156-159,共4页Journal of Practical Medical Imaging

摘　　要：目的分析孤立性肺结节(SPN)的CT征象,并提高诊断水平。方法回顾性分析经临床和病理证实的40例SPN的CT表现,其中周围型肺癌20例,结核球8例,炎性假瘤8例,错构瘤2例,肺AVM和支气管囊肿各1例,均经胸部CT平扫。30例同时行CT增强,包括周围型肺癌15例,结核球6例,炎性假瘤6例,错构瘤、支气管囊肿及肺AVM各1例。结果长、短毛刺、深分叶及卫星病灶在良、恶性结节组间有显著差异(P<0.05);恶性SPN强化值大于等于30 HU,良性SPN强化值小于30 HU,二者间有统计学差异(P<0.05)。结论 SPN的CT表现多种多样,良恶性结节之间的表现存在许多重叠,特征性的表现很少,需要综合分析这些征象的形态学及强化表现,并密切结合临床及相关实验室检查,才能尽早做出准确诊断。Objective To analyze CT signs of solitary pulmonary nodules（SPNs） and to elevate the diagnostic level.Methods Forty patients with clinically and pathologically proved SPNs which comprised peripheral bronchogenic carcinoma（PBC,n=20）,tuberculoma（TBC,n=8）,inflammatory pseudotumor（IPT,n=8）,hamartoma（HMT,n=2）,arteriovenous malformation（AVM,n=1） and saccular bronchiectasis（SBE,n=1） underwent plain CT scans of the chest.30 patients who included 15 PBC,6 TBC,6 IPT,1 HMT,1 SBE and 1 AVM underwent additional contrast-enhanced CT scans.CT findings of all the patients were analyzed retrospectively.Results Long and short spiculated signs,deep lobulated signs and satellite lesions occurred in malignant and benign SPNs were significant difference（P 0.05）.A threshold value of 30 HU was selected on enhanced CT images to distinguish malignant from benign SPNs,the former was more than 30 HU,while the latter was less than 30 HU and the comparison between the both was statistical difference（P 0.05）.Conclusion CT findings of SPNs were varied and many CT signs occurred in malignant and benign SPNs were overlapped each other i.e.both malignant and benign SPNs lack separate features.In order to differentiate malignant from benign SPNs as soon as possible,it is necessary to perform a comprehensive analysis on CT findings of SPNs combined with clinical manifestations and related laboratory tests.

关 键 词：孤立性肺结节 肺癌 结核球 炎症 体层摄影术 X线计算机 

分 类 号：R563.9[医药卫生—呼吸系统] R816.41[医药卫生—内科学]