摘要
目的 探讨肺球形结核动态CT增强表现及其临床应用价值。方法 对 42例共 5 4个肺部球形结核进行研究 ,增强前后均对病变局部薄层扫描 ,层厚及间隔均为 2 0mm。结果 5 4个球形结核病灶中 5 1个 (94 4% )最大增强CT值均 <2 0HU ,3个 (5 6 % )最大增强CT值≥ 2 0HU。 5 4个病灶中无任何强化型有 2 7个 (5 0 0 % ) ;包膜强化型 2 4个 (4 4 4% ) ;周围强化型 1个 (1 9% ) ;广泛强化型 2个 (3 6 % )。CT平扫对球形结核诊断正确率为 2 5 9% ,增强后提高到 94 4% (χ2 =5 0 1,P <0 0 5 )。广泛强化型和周围强化型病灶抗结核疗效最好 ,包膜强化型次之 ,无任何强化型疗效较差。结论 动态CT增强扫描可以提高球形结核诊断的正确率。不强化或包膜样强化提示结核的诊断。病灶增强特征在一定程度上有助于判断抗结核的疗效。
Objective To assess the features and clinical significance of spiral dynamic CT in patients with pulmonary spheral tuberculosis. Methods The 54 foci in 42 patients with pulmonary spheral tuberculosis were studied. Thin sections at 2 mm thickness and 2 mm interval through the nodular center were obtained before and after administration of contrast material. Results In 54 pulmonary spheral tuberculosis, maximum enhanced CT value in 51(94.4%, 51/54) foci was less than 20 HU, and more than 20 HU in the other 3(5.6%, 3/54) foci. 27(50.0%, 27/54) foci showed no any enhancement, 24 (44.4%, 24/54) foci showed capsular enhancement, 1(1.9%, 1/54) focus showed periphera1 enhancement and 2(3.7%, 2/54) foci showed extensive enhancement. The accuracy of the correct diagnosis was 25.9% in terms of plain CT and 94.4% in terms of enhanced CT scanning. The difference was significant (χ 2=50.1, P <0.05). The curative effect of extensive enhanced foci and peripheral enhanced foci was optimal, capsular enhanced foci was second, and non enhanced foci was barely satisfactory. Conclusion Spiral dynamic CT technique may improve the accuracy of diagnosing pulmonary spheral tuberculosis. No enhancement and/or capsular enhancement were suggestive of tuberculosis. The enhancing character of foci might contribute to assess the curative effect of anti tuberculosis.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2001年第9期651-654,共4页
Chinese Journal of Radiology
