多层螺旋CT动态增强在孤立性肺结节的应用

目的:探讨良恶性孤立性肺结节(SPNs)的动态强化模式,以期提高SPNs的诊断符合率。方法:对96例经病理或随访证实的96例SPNs进行动态扫描,测定SPNs的强化值、灌注值、血流量、血容量及时间密度曲线等动态强化参数指标,比较不同性质SPNs的动态强化参数及其价值。结果:恶性结节的平均强化值高于良性结节,但差异无显著性意义(P>0.05);恶性结节及良性结节A的强化程度明显高于良性结节B(P<0.01)。恶性结节与良性结节A的灌注值显著高于良性结节B(P<0.01);恶性结节血流量及血容量高于良性结节,并且差异有显著性意义(P<0.05);恶性结节与良性结节A的血流量及血容量显著高于良性结节B(P<0.01);良性结节A的血流量及血容量均稍高于恶性结节,但差异无显著性意义(P>0.05)。结论:动态增强CT扫描有助于鉴别孤立性肺结节的性质,结节增强值在20HU以下提示良性,结节增强值≥20HU,可作为诊断恶性结节的一个参考指标。

Application of Dynamic-enhanced Multi-slice Spiral CT in Solitary Pulmonary Nodules

Objective:To evaluate the imaging features of benign and malignant solitary pulmonary nodules (SPNs) using dynamic-enhanced computed tomography (dCT) to improve the accuracy of radiological diagnosis.Methods:Ninety-six patients with SPNs proved by pathological findings or follow-up were studied with dynamic-enhanced 64-slice CT.The enhancement values and time-density curves (TDC) of SPNs were obtained by dyna software,and the perfusion value,blood flow (BF) and blood volume (BV) of SPNs were gained by ROI evaluation.The dynamic-enhanced parameters of benign and malignant SPNs were evaluated.Results:The enhancement values of malignant SPNs were higher than those of benign SPNs,and there was no statistical difference (P>0.05).The enhancement values of malignant SPNs and benign SPNAs were significantly higher than those of benign SPNBs (P<0.01).The perfusion values of malignant SPNs and benign SPNAs were significantly higher than those of benign SPNBs (P<0.01).The BF and BV of malignant SPNs were significantly higher than those of benign SPNs (P<0.05).The BF and BV of malignant SPNs and benign SPNAs were significantly higher than those of benign SPNBs (P<0.01).Though the BF and BV of benign SPNAs were higher than those of malignant SPNs,there was no statistical difference (P>0.05).Conclusion:Dynamic-enhanced CT can help differentiate the nature of SPNs.If the enhancement value of SPNs is less than 20HU,it indicates benign.It appears to be an index of malignancy when the enhancement value is 20HU or more.