肺孤立性肿瘤及肿瘤样病变动态CT增强扫描所见

目的应用动态CT增强扫描对肺孤立性肿痛及肿痛样病变检查,观察分析病变强化特点及形态学表现,提高良恶性鉴别诊断水平。方法对51例直径＜4．5cm肺孤立性肿瘤及肿瘤样病变动态CT增强扫描检查。增强值=病灶最大增强CT值-病灶平扫CT值。规定增强值＜10Hu为不强化,增强值10～20Hu为强化,增强值＞20Hu为明显强化。结果肺癌明显强化,结核球不强化,炎性假瘤和错构瘤可强化或不强化。多数肺良性肿瘤、结核球、炎性假瘤边缘光滑。棘突、毛刺、分叶、脐凹征肺癌多见,良性病变少见。钙化、胸膜凹陷征、良恶性病变均可见到。结论明显强化、棘突、毛刺、分叶、脐凹征是肺癌的重要征象。不强化是结核球的重要征象。边缘光滑多见于肺良性肿瘤和结核球。病变形态学良恶性病变有重叠。动态CT增强扫描对良恶性病变的鉴别提供了重要信息。

The detection findings of pulmonary solitary tumor and tumor-like lesion by enhanced dynamic CT

Objective To find the possible morphological characteristics of pulmonary solitary tumor and tumor-like lesion with enhanced dynamic CT and to improve the diagnosis of pulmonary tumor. Methods Fifty-one patients with pulmonary solitary mass lesions smaller than 4.5cm in diameter were studied with enhanced dynamic scan of CT.Enhanced value(MDD)equaled to the differences between maximum enhanced and non-enhanced CT.The enhanced value was defined as non-intensified lesion when MDD＜10Hu,obvious intensified lesion when MDD＞20Hu and intensified lesion when MDD between 10Hu and 20Hu.Results Pulmonary carcinomas always showed obvious intensified lesions while tuberculoma manifested non-intensified lesions,but inflammatory pseudo-tumor and hamartoma displayed either intensified or non-intensified lesions.Most benign tumors,tuberculomas and inflammatory pseudo-tumors were of smooth borders.Pulmonary carcinoma often displaied thorny and leaf sign and umbilicus sign.Both of benign and malignant lesions may display calcification and show off pleural sunken sign.Conclusions Obvious intensified lesion with thorny,leaf sign or umbilicus sign is a common feature of pulmonary carcinoma.Non-intensified lesion is important for diagnosis of tuberculoma. Smooth border is mainly shown in benign tumor and tuberculoma.The benign and malignant mass may overlap morphologically.