螺旋CT动态增强扫描对孤立性肺结节的鉴别诊断价值

刘玥

DOI：10.16662/j.cnki.1674-0742.2017.11.188

[摘要] 目的 探究分析動态CT增强扫描对孤立性肺结节的诊断价值。方法 随机选取该院2013年1月—2016年1月期间接诊的61例孤立性肺结节患者为研究对象，根据病理分型将其分为良性组（n=21）、炎性组（n=12）和恶性组（n=28），对其临床资料进行回顾性分析，在注射对比剂的30、60、120、180及240 s之后分别对病灶进行扫描，测量并记录病灶CT值，对所有患者的动态CT增强扫描结果和病理检查结果进行比较分析，并绘制3组病灶的时间-密度曲线。结果 与病理检查结果比较，CT动态增强扫描对孤立性肺结节良恶性鉴别诊断的灵敏性为92.86%，特异性为90.91%。良性结节、炎性结节、恶性结节增强扫描后30、60、120、180及240 s的CT值变化差异有统计学意义（P<0.05）。结论 动态CT增强扫描能够对孤立性肺结节的良恶性进行可靠准确的判断，在其诊断中具有很高的临床价值，可以选取30、60和120 s作为扫描时间点，不同类型结节的强化程度、强化特性和时间-密度曲线可以为孤立性肺结节的定性诊断提供可靠的参考依据。

[关键词] 孤立性肺结节；螺旋CT；动态增强扫描；时间-密度曲线

[中图分类号] R445 [文献标识码] A [文章编号] 1674-0742（2017）04（b）-0188-03

Value of Dynamic Contrast-enhance Spiral CT Scanning in Differential Diagnosis of Solitary Pulmonary Nodule

LIU Yue

CT Room， Beijing Sixth Hospital， Beijing， 100007 China

[Abstract] Objective To study and analyze the value of dynamic contrast-enhance spiral CT scanning in differential diagnosis of solitary pulmonary nodule. Methods 61 cases of patients with solitary pulmonary nodule diagnosed in our hospital from January 2013 to January 2016 were selected and divided into three groups according to the pathological types， the clinical data were reviewed， and the lesions were scanned in 30，60，120，180 and 240 s after the injection of contrast agents， and the CT value of lesions was measured and recorded， and the dynamic contrast-enhance spiral CT scanning results and pathological examination results of all patients were compared and analyzed and the time-density carve of lesions of the three groups were drawn. Results Compared with the pathological examination results， the sensitivity and specificity of dynamic contrast-enhance spiral CT scanning in differential diagnosis of solitary pulmonary nodule was respectively 92.86% and 90.91%， and the difference in the CT value changes in the 30，60，120，180 and 240 s after the benign， inflammatory and malignant nodes were statistically significant（P<0.05）. Conclusion The dynamic contrast-enhance spiral CT scanning can accurately and reliably determine the benign and malignant solitary pulmonary nodules with extremely high clinical value in the diagnosis， and we can select the 30， 60 and 120 s as the scan time points， and the enhancement degree of different types of nodules， enhancement features and time-density carve can provide reliable reference for the qualitative diagnosis of solitary pulmonary nodule.

[Key words] Solitary pulmonary nodule； Spiral CT； Dynamic enhancement scan； Time-density carve