肺孤立结节CT增强动态扫描的研究(附36例)

目的：评估肺部孤立结节ＣＴ增强动态扫描特征。方法：３６例肺部孤立结节中恶性肿瘤（均为肺癌）２４例，炎症结节７例，结核球５例。以１００ｍｌ／ｍｉｎ速度静脉注射１．５ｍｌ／ｋｇ体重碘造影剂后行动态薄层扫描，层厚２ｍｍ，层间距２ｍｍ。测量增强前后各层次病灶ＣＴ值。结果：结核球无显著强化，炎症结节及恶性肿瘤均呈显著强化，结核球与炎症结节／恶性肿瘤增强值相比有显著性差异；所有炎症结节，２３例恶性肿瘤及１例结核球呈全部强化型，１例恶性肿瘤呈周边强化型，２例结核球呈环形强化，另外２例结核球无明显强化。结论：（１）结节增强值在２０ＨＵ以下提示结核球，２０～６０ＨＵ为恶性结节的一个指标，６０ＨＵ以上高度提示炎症结节。（２）环形强化提示结核球。

The Study on Solitary Pulmonary Nodule with Contrast-enhanced Dynamic CT

Objective:To evaluate the charateristics of solitary pulmonary nodules(SPNs) by contrast-enhanced dynamic computed tomography.Methods:There were 36 cases with SPNs,of them,24 were primary pulmonary cancinoma,7 were inflammatory nodules and 5 were tuberculomas.Serial thin-section CT seans were performed before and after injection of iodinated contrast medium at 100 ml/min and 1.5 ml/kg body weight.The CT numbers of nodule were calculated before and after enhancement.Results:All palmonary carinoma and inflammatory nodules were enhanced significantly,and tuberculomas had no significant enhancement,23 pulmonary carcinomas,7 inflammatory nudules and 1 tuberculoma showed homogeneous enhancement,1 pulmonary carcinoma showed peripheral enhancement,2 tuberculomas showed capsular enhancement.And other 2 tuberculomas showed little enhancement.Conclusion:(1)On contrast-enhanoed scans,it indicates tuberculoma if the maxium attenuation of nodule is less than 20 HU,while it highly indicates inflammation if the CT attenuation is more than 60 HU.It appears to be a sign of malignancy when the CT attenuations are 20 to 60 HU.(2)Ring-like enhancement may be an indication of tuberculoma.