不同病理类型恶性肺结节的多层螺旋CT表现特征比较  

Comparative analysis of the features of multislices spiral computerized tomography in different pathological types of malignant pulmonary nodules

作　　者：杨文魁 周志刚[2] 张琼[1] 梁志华 赵月 陈勇 周莹[1] 陶兴 Yang Wenkui;Zhou Zhigang;Zhang Qiong;Liang Zhihua;Zhao Yue;Chen Yong;Zhou Ying;Tao Xing(Department of Medical Imaging,the Fifth Clinical Medical College of Henan University of Chinese Medicine,People′s Hospital of Henan University of Chinese Medicine,Zhengzhou People′s Hospital,Zhengzhou 450000,China;Department of Imaging Intervention and Nuclear Medicine,the First Affiliated Hospital of Zhengzhou University,Henan 450000,China;Director′s Office,The Second People′s Hospital of Zhengzhou,Henan 450000,China)

机构地区：[1]河南中医药大学第五临床医学院河南中医药大学人民医院郑州人民医院医学影像科,450000 [2]郑州大学第一附属医院影像介入与核医学科,450000 [3]河南省郑州市第二人民医院院长办公室,450000

出　　处：《实用医技杂志》2022年第7期681-685,共5页Journal of Practical Medical Techniques

基　　金：河南省中医药科学研究专项课题(2019JDZX2124)。

摘　　要：目的 探究不同病理类型恶性肺结节在螺旋CT动态增强扫描下的影像学特征。方法 收集74例恶性肺结节患者的临床病理资料,回顾性分析不同病理类型的恶性肺结节患者的CT增强扫描特征。结果 腺癌和鳞癌结节中的纯磨玻璃样结节和混合型结节的比例显著高于小细胞肺癌结节,而实性结节的比例、毛刺征、癌灶大小低于小细胞癌结节(P<0.05);3种病理类型恶性肺结节的强化方式差异具有统计学意义(P<0.05),腺癌结节的主要表现为均匀强化,而鳞癌结节主要表现为不均匀强化,腺癌和鳞癌结节的强化净增值高于小细胞肺癌结节,且腺癌结节的强化率高于小细胞癌结节(P<0.05);延迟扫描180 s时,小细胞癌结节的廓清率高于腺癌和鳞癌结节;而在延迟扫描600 s时小细胞癌和鳞癌结节的廓清率均高于腺癌结节(P<0.05)。结论 不同病理类型的恶性肺结节在多层螺旋CT动态增强扫描的影像学征象和增强扫描参数方面具有一定的差异,可综合分析肺结节的形态特征和增强扫描参数对不同病理类型的恶性肺结节进行鉴别诊断。Objective To investigate the imaging patterns of different pathological types of malignant pulmonary nodules under dynamic contrast-enhanced spiral Computed Tomography(CT).Methods The clinicopathological data from 74 patients with malignant Comparative analysis of the features of multislices spiral computerized tomography in different pathological types of malignant pulmonary nodules Yang Wenkui1,Zhou Zhigang2,Zhang Qiong1,Liang Zhihua1,Zhao Yue1,Chen Yong1,Zhou Ying1,Tao Xing31Department of Medical Imaging,the Fifth Clinical Medical College of Henan University of Chinese Medicine,People′s Hospital of Henan University of Chinese Medicine,Zhengzhou People′s Hospital,Zhengzhou 450000,China;2Department of Imaging Intervention and Nuclear Medicine,the First Affiliated Hospital of Zhengzhou University,Henan 450000,China;3Director′s Office,The Second People′s Hospital of Zhengzhou,Henan 450000,Chinavely analyzed for enhanced CT imaging patterns of the malignant pulmonary nodules according to different pathological types.Results Compared with small-cell lung cancer(SCLC),lung adenocarcinoma(LUAD)and lung squamous cell carcinoma(LUSC)were significantly more frequent to present with pure or mixed ground-glass nodules,and less likely to manifest solid nodules,spiculation and a large tumor size(P<0.05).The performance of enhancement varied significantly across the three pathological types of malignant pulmonary nodules(P<0.05).In most cases,LUAD nodules showed homogeneous enhancement;LUSC nodules showed inhomogeneous enhancement;LUAD and LUSC nodules showed significantly greater net enhancement than did SCLC nodules;LUAD nodules showed higher enhancement rate than did SCLC nodules(P<0.05).At a scan delay of 180 s,SCLC nodules showed significantly higher percentage washout compared with LUAD and LUSC nodules.At a scan delay of 600 s,both SCLC and LUSC nodules showed significantly higher percentage washout compared with LUAD nodules(P<0.05).Conclusion On dynamic multi-slice spiral contrast-enhanced CT scans,malignant

关 键 词：孤立性肺结节 体层摄影术 螺旋计算机 组织学类型肿瘤 影像特征 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]