摘要
目的探讨HRCT联合双动脉期增强扫描对SPN(SPN)良恶性鉴别诊断的价值。方法回顾分析经病理证实且有完整临床、CT资料的SPN64例,分为2组,研究组为43例肺恶性结节,对照组为28例肺良性结节,术前行HRCT及双动脉期增强检查,对2组SPN的CT形态表现及血流动力学进行比较。结果 HRCT扫描:43例恶性结节正确诊断32例,正确率为74.42%;HRCT联合双动脉期增强扫描正确诊断40例,正确率为93.02%。分叶征、毛刺征、血管集束征及胸膜凹陷征在肺恶性结节中出现的概率分别为76.74%、60.47%、58.14%、53.49%,明显高于良性结节组52.38%、23.81%、19.04%、14.29,差异具有显著统计学差异(P<0.05);肺恶性结节在动脉期早期、晚期强化后CT净增值均高于炎性肉芽肿性结节,但低于炎性结节(P<0.05);恶性结节CT净增值常≥20Hu,炎性肉芽肿结节CT净增值常≤10Hu,炎性结节CT净增值常≥50Hu。通过对结节细微CT形态学及血流动力学进行观察,提高了CT对肺恶性结节的定性诊断效能,其灵敏度、特异度、阳性预测值、阴性预测值分别为92.7%、90.5%、95.0%、86.4%,均高于单独HRCT扫描。结论 HRCT联合双动脉期增强扫描观察SPN的CT形态和强化特点,有助于SPN良恶性的鉴别诊断。
Objective To investigate the value in differential diagnosis of solitary benign or malignant pulmonary nodules by HRCT combined with dual-arterial phase enhanced CT scan. Methods A total of 64 cases with SPN confirmed by pathological examinations in our hospital were retrospectively studied. 43 patients with pulmonary cancer and 25 with benign pulmonary nodules underwent HRCT and dual-arterial phase enhanced CT scan. The comparative data including lesion size,number,distribution,density and hemodynamic performance were analyzed. Results HRCT scan：the correct diagnosis proportion of malignant nodules was 74.42%（32/43）;HRCT combined with dual-arterial phase enhanced CT scan ：the correct diagnosis proportion was 93. 02%（40/43）. Lobulation sign,spicule sign,vascular convergence sign and pleural indentation had higher proportion in malignant pulmonary nodules （76.74%, 60.47%, 58.14%, 53.49%, respectively） than in benign pulmonary nodules （52.38%, 23.81%, 19.04%, 14.29%,respectively）,and the difference was statistically significant （P〈0.05）. The net increment of malignant pulmonary nodules were higher than inflammatory granulomatous nodules both in early arterial phase and advanced arterial phase,but lower than inflammatory nodules （P〈0.05）;The net increment of malignant pulmonary nodules was no less than 20Hu,inflammatory granulomatous nodules was no less than 10Hu,inflammatory nodules was no less than 50Hu. The sensitivity,specificity,positive predictive value and negative predictive value of HRCT combined with dual-arterial phase enhanced CT scan was 92.7%,90.5%,95.0% and 86.4% respectively,which both higher than HRCT. Conclusion CT morphologic features and enhanced characteristic of SPN in HRCT combined with dual-arterial phase enhanced CT scan was contributed to differential diagnosis of solitary benign or malignant pulmonary nodules.
作者
李丰章
李丰
潘朝阳
胡兆鹏
LI Fengzhang;LI Feng;PAN Chaoyang(Department of Radiology,2.Department of Thoracic Surgery,3.Department of Pathology,People＇s Hospital of Pingxiang,Pingxiang 337000,China.)
出处
《江西医药》
CAS
2018年第8期810-813,共4页
Jiangxi Medical Journal
基金
江西省萍乡市指导性科技计划项目
编号2017N035
关键词
X线断层摄影术
X线计算机
SPN
动态增强
Tomogra phy
X-ray computed
Solitary pulmonary nodules
Dynamic enhanced scan
