论文部分内容阅读
目的 探讨动态增强CT扫描对肺孤立性结节病变的良恶性鉴别诊断价值。方法 经病理证实的 117肺孤立性结节 ,平扫后 ,以 2ml/秒速率注入造影剂后 1、2、3、4、5分钟薄层扫描。分析强化值、时间 -密度曲线及强化形态。将CT表现与富血管度作相关性分析。结果 恶性结节的强化 3 9 6± 15 8Hu明显高于良性结节 19 18± 17 2 3Hu(P <0 0 1)。以强化值 15Hu为阈值 ,敏感性 10 0 % ( 5 7/ 5 7) ,特异性 63 3 % ( 3 8/ 60 ) ,准确性 82 9% ( 97/ 117)。周围型肺癌的主要强化形态是完全性强化及周围性强化。结核瘤的主要强化形态是无强化及包膜样强化 (分别为 19例、16例 ) ,占 92 %。结节的强化值与肿瘤中央血管数目呈正相关 ,与微血管密度呈等级正相关。结论 强化值≤ 15Hu ,提示良性结节 ;恶性结节较良性结节更富血管 ,其强化也明显高于良性结节。炎性假瘤及部分错构瘤是产生假阳性的主要原因 ,动态曲线的分析有助于鉴别
Objective To investigate the differential diagnosis of benign and malignant solitary pulmonary nodules with dynamic contrast-enhanced computed tomography. Methods Pathologically confirmed pulmonary solitary nodules of 117 were dissected, and 2, 3, 4, 5 minutes after injection of contrast agent at a rate of 2 ml / sec. Analyze fortified values, time-density curves and fortified forms. Correlation analysis of CT findings and vascularization. Results The enhancement of malignant nodules was 396 ± 15 8Hu which was significantly higher than that of benign nodules 19 18 ± 17 2 3Hu (P <0.01). With the threshold of 15Hu, the sensitivity was 100% (57/57), the specificity was 63.3% (38/60) and the accuracy was 82.9% (97/117). The main enhanced form of peripheral lung cancer is complete enhancement and peripheral enhancement. The main enhanced form of tuberculoma is no enhancement and envelope-like enhancement (19 cases, 16 cases), accounting for 92%. The enhancement value of nodules was positively correlated with the number of central blood vessels in the tumor and positively correlated with the microvessel density. Conclusion The enhanced value of ≤ 15Hu, suggesting benign nodules; malignant nodules than benign nodules more vascularized, and its enhancement is also significantly higher than that of benign nodules. Inflammatory pseudotumor and some hamartomas are the main causes of false positive, dynamic curve analysis helps to identify