CT同层动态增强扫描对肺内孤立性结节的鉴别诊断

目的： 探讨CT同层动态增强扫描鉴别肺内良、恶性结节的临床价值。 方法：利用CT同层动态增强扫描方法对39例肺内孤立性结节（SPNs）患者的不同增强模式进行分析，并绘制SPNs强化的时间-密度曲线、测量其强化峰值和CT净增值。 结果：良、恶性结节强化后具有不同的时间-密度曲线模式和CT净增值。肺癌的CT净增值［（41.9±2.8）］Hu高于结核的CT净增值［（11.7±7.85）Hu］（P<0.01）；炎性结节的CT净增值［（43.6±7.7）Hu］与肺癌的CT净增值比较差异无显著性(P>0.05)。但肺癌的时间-密度曲线为初始急剧上升后缓慢下降，最后保持稳定水平；炎性结节曲线呈持续上升（无下降）趋势；肺结核的曲线呈平缓走行，无明显起伏。结论：CT同层动态增强扫描是用一种无创性方式对SPNs血流模式提供定量信息。

Differential diagnosis of solitary pulmonary nodules by using single-location dynamic enhanced CT

Objective To study the clinical efficacy of differential diagnosis between malignant and benign solitary pulmonary nodules (SPNs) with single-location dynamic enhanced computed tomography (CT). Methods Thirty-nine patients were studied with single-location dynamic enhanced CT. Patterns of time-density curve were drawn. Peak height and increment of CT value were calculated. Results Malignant and benign SPNs showed quite different patterns in time-density curve. Enhanced degree of pulmonary carcinoma (41.9±2.8)Hu]was higher than that of the tuberculosis(11.7±7.85)Hu], which had significant difference (P<0.01). However, here was no significant difference of enhanced degree between pulmonary inflammatory(43.6±7.7)Hu] and pulmonary carcinoma SPNs (P>0.10).But the time-density curve of malignant SPNs tend to achieve rapid enhancement- to-peak attenuation and eventually reached a plateau. Inflammatory SPNs showed gradual enhancement without obvious attenuation. The curve of tuberculosis was placid. Conclusion Single-location dynamic contrast enhanced CT is a non-invasive option and can provide quantitative information about blood flow patterns of SPNs.