螺旋高分辨率CT对肺内孤立性结节良恶性鉴别诊断的研究

目的 :前瞻性研究螺旋高分辨率 CT(HRCT)对肺内孤立性结节 (SPN)的定性价值。材料与方法 :对 98例肺内孤立性结节行常规螺旋扫描 (SCT) ,构成对照组 ,在结节处加 HRCT扫描 ,构成目的组 ,在双盲的前提下 ,由二个水平相当的独立诊断小组对两组资料图像的外观形态、内部结构、结节—肺界面、邻近改变、CT血管征进行观察、描述、记录并诊断 ,最后与病理嵌合 ,χ2 比较二组资料的诊断正确率。结果 :SCT诊断正确率为 6 7.3% (6 6 /98) ,HRCT诊断正确率为 89.8% (88/98) ,HRCT在显示钙化、密度、坏死、空泡征、细短毛刺、胸膜凹陷征、晕征、血管支气管征方面优于 SCT(P<0 .0 5 ) ,而显示外观形态 ,粗长毛刺、锐利度、肺气肿征方面差异无显著性 (P>0 .0 5 )。良性倾向性征象包括 :边界锐利如笔画、钙化、密度均匀、粗长毛刺、周围肺气肿征、晕征 ;恶性倾向性征象包括 :细短毛刺、分叶、血管支气管征、胸膜凹陷征、坏死、空泡征。结论 :HRCT有助于 SPN征象的显示 ,有助于诊断与鉴别诊断 ,应列为 SPN检查常规。

A Differentiating Study of Solitary Pulmonary Nodules with High Resolution Computed Tomography

Objective To study prospectively the val ue of high resolution computed tomography(HRCT) in the differentiating of solita ry pulmonary nodules(SPN).Materials and methods The experimental group and control group consist of Spiral CT(SCT) and high resolution CT(HRCT) f indings in 98 SPN. The characteristics of each nodule’s external morphology, i nternal architecture, nodule-pulmonary interface, neighboring structural change s , vesselsign were observed, described, registered and diagnosed with double blin d method. And pathologically or other ways-proved ultimately. Statistical meth o d was χ2 test. Results The accurate of SCT and HRCT was 67.3 %( 66/98) and 89.8 %(88/98) respectively. HRCT was useful in demonstrating calcification, density, necrosis, vacuole sign, Fine-short spiculation, pleural indentation, halo sign and vesselsign of the SPN compare with SCT. Sharp margin, calcification, uniform ity density, long spiculation, emphysema, halo sing were appeared in benignancy nodules more often compare with Fine-short spiculaton, lobulation, vesselsign, p leural indentation, necrosis and vacuole sign appeared in malignancy more often. Conclusions HRCT was superior to SCT in demonstrating the characte ristic signs of SPN and the differentiating of SPN. The authors recommended HRCT to be routine choice in improve accuracy of diagnosis and differential diagnosi s of SPN.