螺旋CT動(dòng)態(tài)增強(qiáng)掃描對(duì)孤立性肺結(jié)節(jié)的鑒別診斷價(jià)值

劉玥

DOI：10.16662/j.cnki.1674-0742.2017.11.188

[摘要] 目的 探究分析動(dòng)態(tài)CT增強(qiáng)掃描對(duì)孤立性肺結(jié)節(jié)的診斷價(jià)值。方法 隨機(jī)選取該院2013年1月—2016年1月期間接診的61例孤立性肺結(jié)節(jié)患者為研究對(duì)象，根據(jù)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(duì)其臨床資料進(jìn)行回顧性分析，在注射對(duì)比劑的30、60、120、180及240 s之后分別對(duì)病灶進(jìn)行掃描，測(cè)量并記錄病灶CT值，對(duì)所有患者的動(dòng)態(tài)CT增強(qiáng)掃描結(jié)果和病理檢查結(jié)果進(jìn)行比較分析，并繪制3組病灶的時(shí)間-密度曲線。結(jié)果 與病理檢查結(jié)果比較，CT動(dòng)態(tài)增強(qiáng)掃描對(duì)孤立性肺結(jié)節(jié)良惡性鑒別診斷的靈敏性為92.86%，特異性為90.91%。良性結(jié)節(jié)、炎性結(jié)節(jié)、惡性結(jié)節(jié)增強(qiáng)掃描后30、60、120、180及240 s的CT值變化差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 動(dòng)態(tài)CT增強(qiáng)掃描能夠?qū)铝⑿苑谓Y(jié)節(jié)的良惡性進(jìn)行可靠準(zhǔn)確的判斷，在其診斷中具有很高的臨床價(jià)值，可以選取30、60和120 s作為掃描時(shí)間點(diǎn)，不同類型結(jié)節(jié)的強(qiáng)化程度、強(qiáng)化特性和時(shí)間-密度曲線可以為孤立性肺結(jié)節(jié)的定性診斷提供可靠的參考依據(jù)。

[關(guān)鍵詞] 孤立性肺結(jié)節(jié)；螺旋CT；動(dòng)態(tài)增強(qiáng)掃描；時(shí)間-密度曲線

[中圖分類號(hào)] R445 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 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