螺旋CT動態增強掃描對孤立性肺結節的鑒別診斷價值

劉玥

DOI：10.16662/j.cnki.1674-0742.2017.11.188

[摘要] 目的 探究分析動態CT增強掃描對孤立性肺結節的診斷價值。方法 隨機選取該院2013年1月—2016年1月期間接診的61例孤立性肺結節患者為研究對象，根據病理分型將其分為良性組（n=21）、炎性組（n=12）和惡性組（n=28），對其臨床資料進行回顧性分析，在注射對比劑的30、60、120、180及240 s之后分別對病灶進行掃描，測量并記錄病灶CT值，對所有患者的動態CT增強掃描結果和病理檢查結果進行比較分析，并繪制3組病灶的時間-密度曲線。結果 與病理檢查結果比較，CT動態增強掃描對孤立性肺結節良惡性鑒別診斷的靈敏性為92.86%，特異性為90.91%。良性結節、炎性結節、惡性結節增強掃描后30、60、120、180及240 s的CT值變化差異有統計學意義（P<0.05）。結論 動態CT增強掃描能夠對孤立性肺結節的良惡性進行可靠準確的判斷，在其診斷中具有很高的臨床價值，可以選取30、60和120 s作為掃描時間點，不同類型結節的強化程度、強化特性和時間-密度曲線可以為孤立性肺結節的定性診斷提供可靠的參考依據。

[關鍵詞] 孤立性肺結節；螺旋CT；動態增強掃描；時間-密度曲線

[中圖分類號] R445 [文獻標識碼] A [文章編號] 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