肺孤立性结节薄层动态螺旋CT扫描与病理研究

目的　探讨薄层动态螺旋CT扫描对孤立性肺结节 (SPN)的诊断与鉴别诊断价值。方法　对 3 8例SPN先行薄层平扫 ,再注入优维显 10 0ml ,延迟 3 0s、1min、2min、5min、10min及 15min薄层动态扫描。结果　肺癌、炎性假瘤强化程度明显高于结核与错构瘤 ,以 2 0HU为CT差阈值 ,敏感性为 10 0 % ,特异性为 96% ;肺癌强化峰值约为 2min ,炎性假瘤约为 5min ;炎性假瘤强化持续时间较肺癌长 ;结核与错构瘤均无明显强化 ,但部分结核有典型环形强化。薄层扫描能更多地发现有鉴别诊断意义的征象 ,对CT值的测量更准确。结论　薄层动态螺旋CT扫描对SPN有重要诊断与鉴别诊断价值

Solitary Pulmonary Nodule:Dynamic Spiral CT Scan of Thin Collimation with Pathology Study

Objective To evaluate the diagnosis and differentiation of solitary pulmonary nodule (SPN) using dynamic spiral CT scan of thin collimation.Methods The thin collimation no-enhanced CT scan and contrast enhanced scan in 30 seconds,1 minute,1 minutes,2 minutes,5 minutes,10 minutes,and 15 minutes after administration of media 100 ml were performed in 38 cases. Results The mean enhanced CT numbers of lung cancer and inflammatory pseudotumor were much higher than that of tuberculosis(TB) and hamartoma and statistically significant in different time of enhancement;20 HU was the threshold for a positive test,the sensitivity was 100% and the specificity was 96%.In time-attenuation curve analysis,lung cancer reached peak enhancement about 2 minutes,inflammatory pseudotumor in 5 minutes and keep longer enhanced time than that of lung cancer.No marked enhancement in SPN of TB and harmatoma,but ring-shaped enhancement can be seen in some of TB.More valuable imaging signs were found with thin collimation scan and more accurate to measure the CT numbers than traditional scan.Conclusion Dynamic spiral CT scan of thin collimation is a very valuable method for diagnosis and differentiation of SPN.