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1、CT動態(tài)增強掃描對肺內孤立性小結節(jié)的鑒別診斷價值第42卷第l期2006年12月青島大學醫(yī)學院ACTAACADEMIAEMEDICINAEQINGDA0UNIVERSITATISVo1.42,No.4December2006CT動態(tài)增強掃描對肺內孤立性小結節(jié)的鑒別診斷價值林吉征,孫德寶,李穎端,李紹科,楊學東,路曉東(1青島大學醫(yī)學院附屬醫(yī)院放射科,山東青島266003;2青島大學醫(yī)療集團海陽醫(yī)院放射科)[摘要]目的探討動態(tài)增強CT掃描對肺內孤立性小結節(jié)的鑒別診斷意義.方法經(jīng)手術病理證實肺內孤立小結節(jié)6o例,其中小肺癌38例,炎性結節(jié)1o例,結核球12例,術前均行CT平掃
2、及注藥后30s,1rain,2rain,3min,4min,5rain,6rain的動態(tài)增強掃描.根據(jù)病灶平掃CT值及不同時間增強掃描CT值,做出不同病變CT值的時間一密度曲線.結果小肺癌與結核,炎癥的平掃CT值無顯著差異.結核球的強化程度明顯低于小肺癌和炎性結節(jié),但炎性結節(jié)與小肺癌的CT強化程度無顯著差異.小肺癌,炎性結節(jié)和結核球三種病變增強后的時間一密度一曲線形態(tài)和強化形式不同.結論動態(tài)增強CT掃描對肺內孤立性小結節(jié)鑒別診斷有一定意義.[關鍵詞]硬幣病變,肺;體層攝影術,X線計算機;診斷,鑒別[中圖分類號]R816.4[文獻標識碼]A[文章編號]1672—4488(
3、2006)04—0312—03J'HEVA1L】EOFDYNAMICENHANCEDCI'1NDIFFERENTIALDIAGNOSISOFSMALLSOLITARYPULMoNARYNoDULES1.INjIZHENG,SUNDE—BA()1.IYING~DUANetaltDepartmentofRadiologyTheAffiliatedHospitalofQingdaoUniversiIYMedicalCollege,Qingdao266003,China)EABSTRACT~ObjectiveToinvestigatethedynamicenhancedCTsc
4、anningindifferentiationofsmallsolitarypulmonarynodules.MethodsSixtycaseswereconfirmedbyoperationandpathology,38ofthetotalweresmalllungcancer,12weretu—berculoma.and10wereinflammatorynodules.AllcaseswerestudiedwithplainchestCTscananddynamicenhanced(thedelaytimeofscaliswas30sand1,2,3,l,5.6r
5、ainafterinjection)beforesurgery.Thentheenhancementdegreeofthelesionswasrecor—dedatdifferenttiriles.ThetirileattenuatiOncurvesofdifferentdiseasesweremade.ResultsTherewasnosignificantdifferenceinplainCT,alu(amongcancer.inflammatoryandtuberculoma.Tuberculomashowedasignificantlylowerdegreeof
6、enhancementthanthecancerandinflammatorynodules.Thecarcinomaandtheinflammationshowednodifferenceindegreeofenhancement.Butthetimeattenuationcurvesofthe1hreekindsoflesionsafterinjectionofcontrastmediumappearedtobedifferentandtheenhaneenlOll
7、modalityofthethreekindsoflesionsweredifferen
8、tOO.C
9、onclusionThedynamicenhancedCTscanningisofcertainvaluetodifferentialdiagnosisofsmallsolitarypulmonarynodules.KEYWORDS]coinlesion.pulmonary;tomography.X—raycomputed;diagnosis,differential肺內孤立結節(jié)的鑒別診斷一直是影像學研究的熱點.】,由于惡性結節(jié)的血管生成過程,血供與良性結節(jié)有顯著的差別,這就為利用影像學技術鑒別肺結節(jié)的良,惡性提供了可能性.本文對6O例肺
