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1、CT动态增强扫描对肺内孤立性小结节的鉴别诊断价值第42卷第l期2006年12月青岛大学医学院ACTAACADEMIAEMEDICINAEQINGDA0UNIVERSITATISVo1.42,No.4December2006CT动态增强扫描对肺内孤立性小结节的鉴别诊断价值林吉征,孙德宝,李颖端,李绍科,杨学东,路晓东(1青岛大学医学院附属医院放射科,山东青岛266003;2青岛大学医疗集团海阳医院放射科)[摘要]目的探讨动态增强CT扫描对肺内孤立性小结节的鉴别诊断意义.方法经手术病理证实肺内孤立小结节6o例,其中小肺癌3
2、8例,炎性结节1o例,结核球12例,术前均行CT平扫及注药后30s,1rain,2rain,3min,4min,5rain,6rain的动态增强扫描.根据病灶平扫CT值及不同时间增强扫描CT值,做出不同病变CT值的时间一密度曲线.结果小肺癌与结核,炎症的平扫CT值无显着差异.结核球的强化程度明显低于小肺癌和炎性结节,但炎性结节与小肺癌的CT强化程度无显着差异.小肺癌,炎性结节和结核球三种病变增强后的时间一密度一曲线形态和强化形式不同.结论动态增强CT扫描对肺内孤立性小结节鉴别诊断有一定意义.[关键词]硬币病变,肺;体层
3、摄影术,X线计算机;诊断,鉴别[中图分类号]R816.4[文献标识码]A[文章编号]1672—4488(2006)04—0312—03J'HEVA1L】EOFDYNAMICENHANCEDCI'1NDIFFERENTIALDIAGNOSISOFSMALLSOLITARYPULMoNARYNoDULES1.INjIZHENG,SUNDE—BA()1.IYING~DUANetaltDepartmentofRadiologyTheAffiliatedHospitalofQingdaoUniversiIYMedicalColl
4、ege,Qingdao266003,China)EABSTRACT~ObjectiveToinvestigatethedynamicenhancedCTscanningindifferentiationofsmallsolitarypulmonarynodules.MethodsSixtycaseswereconfirmedbyoperationandpathology,38ofthetotalweresmalllungcancer,12weretu—berculoma.and10wereinflammatorynod
5、ules.AllcaseswerestudiedwithplainchestCTscananddynamicenhanced(thedelaytimeofscaliswas30sand1,2,3,l,5.6rainafterinjection)beforesurgery.Thentheenhancementdegreeofthelesionswasrecor—dedatdifferenttiriles.ThetirileattenuatiOncurvesofdifferentdiseasesweremade.Resul
6、tsTherewasnosignificantdifferenceinplainCT,alu(amongcancer.inflammatoryandtuberculoma.Tuberculomashowedasignificantlylowerdegreeofenhancementthanthecancerandinflammatorynodules.Thecarcinomaandtheinflammationshowednodifferenceindegreeofenhancement.Butthetimeatten
7、uationcurvesofthe1hreekindsoflesionsafterinjectionofcontrastmediumappearedtobedifferentandtheenhaneenlOll
8、modalityofthethreekindsoflesionsweredifferen
9、tOO.ConclusionThedynamicenhancedCTscanningisofcertainvaluetodifferentialdiagnosisofsmallsolitarypulmonarynodule
10、s.KEYWORDS]coinlesion.pulmonary;tomography.X—raycomputed;diagnosis,differential肺内孤立结节的鉴别诊断一直是影像学研究的热点.】,由于恶性结节的血管生成过程,血供与良性结节有显着的差别,这就为利用影像学技术鉴别肺结节的良,恶性提供了可能性.本文对6O例肺
