多层螺旋CT对DR体检发现的无症状孤立性肺结节的诊断价值  

Diagnostic value of MSCT in asymptomatic SPN through DR chest physical examination

作　　者：李基根 符喻矗 聂世琨[2] 

机构地区：[1]广州军区广州疗养院放射科,广东广州510515 [2]南方医科大学附属珠江医院放射科,广东广州510282

出　　处：《中国医学装备》2015年第8期74-78,共5页China Medical Equipment

摘　　要：目的:探讨多层螺旋CT对在DR体检发现的无症状孤立性肺结节(SPN)诊断中的应用价值。方法:回顾性分析10例影像资料齐全,且经手术确诊的无症状SPN患者的DR、CT及PET/CT和手术病理资料。结果:10例患者DR检查发现肺内孤立性结节影;CT扫描后诊断考虑肺癌8例、肺结核瘤1例、肺部炎性结节1例。8例肺癌中,显示分叶征7例、毛刺征6例、胸膜侵犯或凹陷征5例、血管集束征1例、空泡征1例。PET/CT扫描放射性浓聚中等以上8例,轻度2例。手术病理示肺腺癌8例、结核瘤1例、肉芽肿性炎病变1例,与CT诊断符合率为100%。结核瘤与肺癌在PET/CT检查中均表现为中度以上浓聚,1例代谢低度浓聚者病理为肺腺癌。结论:多层螺旋CT是检查DR发现的无症状SPN最有价值的影像设备,精细扫描加上图像后处理技术寻找SPN的良和(或)恶性征象,对DR体检发现的无症状SPN的良恶性诊断和鉴别诊断具有十分重要的意义。Objective： To explore the application value of MSCT in diagnosis of asymptomatic SPN through DR Chest Physical Examination. Methods： A retrospective analysis of 10 cases of complete image and pathological data of DR, CT, PET/CT confirmed by surgery in asymptomatic patients with SPN. Results： Solitary pulmouary nodules were diagnosed in the 10 patients with DR during chest examination. MSCT scanning indicated 8 cases of pulmonary cancers,one case of tuberculoma and one case of pulmonary inflannatory nodule. In 8 cases of pulmonary cancers,there found lobulation（7cases）, spiculate（6cases）, pleural invasion sign（5cases）, vascular cluster sign（one case）, and air-bronchogram（one case）. PET/CT scanning testified 8 cases with above medium FDG uptake and 2 cases with mild FDG uptake. Surgical pathology showed 8 cases with lung adenocarcinoma,one case with tuberculoma and one case with granulomatous inflammation.The overall accurate diagnostic rate with MSCT was 100%. Tuberculosis and lung tumors in PET/CT examination showed above moderate FDG uptake, and one case of low FDG uptak was confirmed for pulmonary cancer by histopathology. Conclusion： MSCT is the most valuable imaging equipment in examination of asymptomatic SPN. Fine scanning with image post processing techniques is significant in the diagnosis of begnign and malignant asymptomatic SPN.

关 键 词：数字X线摄影 肺结节 体层摄影术 X射线计算机 肺癌 

分 类 号：R816.41[医药卫生—放射医学]