最大径≤1cm肺小结节螺旋CT靶扫描及重建的良恶性判断分析

目的探析螺旋CT靶扫描及重建在最大径≤1cm肺小结节良恶性判断中的应用价值。方法选取2017年1月至2019年3月50例我院病理证实,且直径≤1cm肺部小结节患者进行回顾性分析,所有患者均接受螺旋CT靶扫描及重建,通过观察小结节的形态、内部结构、边缘特征、邻近结构改变等情况,判断小结节的良恶性。结果 50例患者中包括恶性22例(浸润性腺癌16例,微浸润腺癌3例,小细胞癌2例,鳞癌1例),良性28例(不典型瘤样增生11例,炎性肉芽肿12例,结核肉芽肿3例,错构瘤2例)。比较分析良恶性小结节的螺旋CT靶扫描及重建图像,恶性病灶的直边征、钙化率明显低于良性病灶,而深分叶征、毛刺征、血管集束征、胸膜凹陷征、空泡征、晕征比例明显高于良性病灶,差异有统计学意义(P<0.05)。结论螺旋CT靶扫描及重建技术能够更清晰地显示肺小结节的形态、内部结构、边缘特征及邻近结构改变,对最大径≤1cm肺小结节良恶性判断具有重大价值。

Benign and Malignant Judgment of Targeted Spiral CT Scanning and Reconstruction Techniques in Small Pulmonary Nodules of 1cm or Less in Maximal Diameter

Objective To explore the value of targeted spiral CT scanning and reconstruction techniques in the diagnosis of benign and malignant pulmonary nodules of 1 cm or less in maximal diameter. Methods Fifty cases of pulmonary nodules of 1 cm or less in maximal diameter confirmed by pathology were analyzed retrospectively. All cases were performed by spiral CT target scanning and reconstruction techniques, by observing the nodular morphology, internal structure, edge feature, adjacent structural change, so as to differentiate the benign from malignant nodules. Results Among the 50 cases, 22 were malignant(16 cases of infiltrating adenocarcinoma, 3 cases of minimally invasive adenocarcinoma, 2 cases of small cell carcinoma, 1 case of squamous carcinoma), and 28 were benign(11 cases of atypical adenomatous hyperplasia, 12 cases of inflammatory granulomas, 3 cases of tuberculous granulomas, 2 cases of hamartoma). Comparing the CT manifestations of benign and malignant cases, the straight sign and calcification rate of malignant lesions were significantly lower than those of benign, and deep lobulation sign, speculation, vessel convergence sign, pleural indentation, vacuole sign, halo sign were higher than the latter. Conclusion Targeted spiral CT scanning and reconstruction techniques can display the nodular morphology, internal structure, edge feature, adjacent structural change more clearly, which perform an important value for diagnosis of benign and malignant pulmonary nodules of 1 cm or less in maximal diameter.