多平面重建对肺内孤立结节的评价

目的:探讨多层螺旋CT多平面重建技术(MPR)对肺内孤立性结节(SPN)的诊断价值。资料与方法:39例SPN行多层螺旋CT扫描、轴位HRCT扫描及薄层冠状位、矢状位MPR重建。图像分析分为2种方法,方法A为螺旋CT轴位图像结合轴位HRCT图像,方法B为螺旋CT轴位图像结合薄层冠状和矢状位多平面重建图像。判断方法A和方法B对SPN基本形态和基本征象的评价有无不同。结果:方法A和方法B对39例SPN基本形态和征象评价的差别无统计学意义。螺旋CT结合轴位HRCT的方法将2例炎症误诊为肺癌,螺旋CT结合MPR图像则作出正确诊断。与MPR图像比较分析后发现,轴位图像未能真实显示病灶的基本形态。结论:薄层MPR在显示SPN的基本征象方面同HRCT的作用相同、在评价SPN的基本形态方面优于单纯轴位CT。

Evaluation of multiplanar reformation in the diagnosis of solitary pulmonary nodule

Objective: To investigate the usefulness of multiplanar reformation of multi-slice spiral CT(MSCT) in the diagnosis of solitary pulmonary nodule(SPN). Materials and Methods: Thirty-nine patients with pathologically and clinically proved small peripheral lung cancer and benign nodules underwent MSCT and transverse HRCT. Coronal and sagittal multiplanar reformation(MPR) were obtained on workstation. MPR images were compared with transverse HRCT images. Results: No significant difference was found in the identification of CT features of SPN between thin-slice MPR and transverse HRCT. Two cases with clinically proved focal pneumonia were misdiagnosed as small lung cancer by MSCT combined with HRCT, and correct diagnoses as made by MSCT combined with thin-slice MPR, based on the interpretation of the basic morphology of the lesion. Conclusion: Thin-slice MPR images demonstrate the basic characteristic signs of SPN as precisely as that provided with transverse HRCT scans. MPR is superior to transverse HRCT scans in evaluation of the basic shape of SPN.