孤立性肺结节的CT征象及早期MSCT的应用价值

目的研究孤立性肺结节的CT征象及早期MSCT的应用价值。方法回顾性分析三种类型孤立性肺结节患者的CT征象,74例患者均进行CT平扫、增强扫描及灌注成像扫描,比较良性、炎性、恶性孤立性肺结节的灌注参数:血流量(BF)、血容量(BV)、表面通透性(PS)及平均通过时间(MTT)之间的差异。结果恶性结节:37例恶性结节中31例边界清晰,占83.78%,分叶征27例,占72.97%,毛刺征22例,占59.46%,胸膜凹陷征17例,占45.95%,10例棘状突起,2例出现钙化,无卫星病灶表现;良性结节:16例良性结节患者均表现为边界清晰,15例有钙化灶,占93.75%,少见结节内亮影,棘状突起及分叶,且仅有1例有胸膜凹陷征及毛刺;炎性结节:炎性结节21例内卫星病灶12例,占57.14%,11例可见棘状突起,占52.38%,以上两者为主要征象,少见空洞、钙化及分叶征象。BV、PS、BF、MTT值四项指标中,恶性患者PS值较炎性患者显著较高(P0.05),其他灌注参数比较无统计学意义(P0.05),两组与良性结节患者比较BV、PS、BF、MTT均有统计学意义(P0.05)。结论孤立性肺结节不同病理类型的CT征象存在显著差异,且炎性、恶性结节与良性结节比较CT灌注参数差异明显,而PS值可作为炎性与恶性鉴别的可靠依据。

CT Findings of Solitary Pulmonary Nodules and the Application Value of MSCT at Early Stage

Objective To study the CT findings of solitary pulmonary nodules and the application value of MSCT at early stage.Methods The CT findings of patients with the three kinds of solitary pulmonary nodules were retrospectively analyzed. All of the 74 patients underwent CT plain scan, enhanced scan and perfusion scan. The perfusion parameters of benign, inflammatory and malignant solitary pulmonary nodules were compared, including blood flow (BF), blood volume (BV), permeability surface (PS) and mean transit time (MTT).Results In terms of malignant nodules, among 37 cases of malignant nodules, there 31 cases with clear boundaries, accounting for 83.78%, 27 cases with lobulation, accounting for 72.97%, 22 cases with spiculation signs, accounting for59.46% and 17 cases with pleural indentation signs, accounting for45.95%. There were 10 cases of spiculate protuberance, 2 cases showing calcification and none satellite lesions. In terms of benign nodules, 16 cases of patients with benign nodules showed clear boundaries, 15 cases with calcification, accounting for 93.75%, with few light shadowwithin nodules, spiculate protuberanceand leaflets. There was only 1 case with pleural indentation signs and spiculation; In terms of inflammatory nodules, among the 21 cases of inflammatory nodules, there were 12 cases with satellite lesions, accounting for 57.14% and 11 cases with spiculate protuberance, accounting for 52.38%. Both of the above two were the main signs, with rare cavity, calcification and lobulation. BV, PS, BF, MTT value of four indicators, malignant patients with PS value is significantly higher than the inflammatory (P<0.05), There was no significant difference in other perfusion parameters (P>0.05). There were significant differences in BV, PS, BF and MTT between the two groups and the patients with benign nodules (P<0.05).Conclusion The CT findings of different pathological types ofsolitary pulmonary nodules are significantly different.There are significant differences in CT perfusion parameters between patients with inflammatory, malignant nodules and patients with benign nodules. However, PS value can be used as a reliable basis for the identification of inflammatory and malignant lesions.