肺孤立性结节的CT探讨(附38例分析)

目的:观察肺内孤立性结节灶(≤3cm)形态特点,主要分析CT扫描(包括薄扫、HRCT)对良恶性病变定性诊断的作用。材料和方法:选择肺内孤立结节38例,采用常规平扫,增强及薄层、HRCT技术,对其病灶内部、边缘、周围改变特征进行分析。结果:恶性结节28例,良性结节10例。由手术病理证实,CT诊断正确率71％。仅见于恶性结节的征象有空泡征、空气支气管征,深分叶征,脐凹征,周围支气管变形,周围局限性肺气肿等。其余一些征象既见于恶性结节灶,也见于良性结节灶,就其在两类结节灶中的出现率而言,短毛刺、棘状突起,血管集束征,胸膜凹陷征多见于恶性结节,出现率53％～71％。而浅分叶征,长毛刺征、轨道征,卫星灶多见于良性病变,出现率30～50％,结论:对SPN进行CT薄扫、HRCT技术对提高病变特征显示率有意义,能做出大部分良恶性病变的定性诊断。对于缺乏特异性病变者应根据多个良性或恶性征象进行判断,结合临床,综合考虑。

Research into CT Features of Solitary Pulmonary Nodes: Results in 38 patients.

Purpose: To observe CT features of solitary pulmonary nodes (D <3cm), in particular, to analyze emphatically the role of CT scanning in the differential diagnoses between benign nodes and malignant nodes. Materials and Methods: We selected 38 cases of patients with solitary pulmonary nodes and analyzed the characteristic changes of nodous inside, nodous edge, and nodous periphery by conventional general scanning, enhancing, thin layer scanning, and HRCT technique. Results: 28 patients with malignant nodes and 10 patients with benign nodes were be demonstrated from postoperative pathologic diagnoses. The accuracy of CT diagnoses was71% Some signs such as vascuole sign, air - bronchus sign, deep - fissured sign, umbilical depression sign, peripheral bronchus deformation, and peripheral located emphysema were found only in malignant nodous foci however, otherwise signs cauld be found whether in malignant nodes or in benign nodes. For the case of their found - out rate, short fin sign, spinous process, vascular concentrative beam sign, and pleura depression sign were largely found in malignant nodous foci, the found - ouf rate was 53 - 71% , but quite the contrary, shallow fissured sign, long fin sign, track sign, and satellite foci were largely found in benign nodous foci and their found - out rate was 30 - 50% . Conclusion: CT thin Scanning and HRCT technique greatly contribute to display the characteristic changes of solitary pulmonary nodes and the majority of noduos foci including both malignant foci and benign foci could be differentially diagnosed. In absence of characteristic changes, the qualitalive diagnoses between malignant foci and benign foci should perform the overall consideration combined with clinical symptoms.