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目的:初步探讨显示恶性孤立肺结节分叶征理想CT层厚。方法:45例恶性孤立肺结节(直径≤3 cm)患者,经屏气训练后,采用64层螺旋CT行胸部扫描(准直器宽度0.625 mm×64)。分别重组成1、2、5 mm等3组图像,比较3组图像对恶性孤立肺结节分叶征显示的异同。以1 mm图像显示的结节分叶征为标准,分析恶性孤立肺结节分叶,判断2、5 mm组图像显示恶性孤立肺结节分叶征的可靠性。结果:1 mm图像显示45例恶性孤立肺结节共出现98个分叶,其中弦距<1 mm分叶25个,弦距为1～2 mm分叶30个,弦距>2 mm分叶43个。2 mm图像上显示弦距<1 mm分叶与1 mm图像上显示分叶一致的有18个,两者数量有显著差异(P=0.023<0.05)。5 mm图像上显示弦距<1 mm分叶与1 mm图像上显示分叶一致的有16个,两者数量有显著差异(P=0.004<0.05)。2 mm图像上显示弦距为1～2 mm分叶与1 mm图像上显示分叶一致的有24个,两者数量无显著差异(P=0.261>0.05)。5 mm图像上显示弦距为1～2 mm分叶与1 mm图像上显示分叶一致的有13个,两者数量有显著差异(P=0.003<0.05)。2 mm图像上显示弦距>2 mm分叶与1 mm图像上显示分叶一致的有40个,两者数量无显著差异(P=0.631>0.05)。5 mm图像上显示弦距>2 mm分叶与1 mm图像上显示分叶一致的有36个,两者数量无显著差异(P=0.264>0.05)。结论:恶性孤立肺结弦距<1 mm时1mm层厚较合适,弦距为1～2 mm时2 mm层厚较合适,弦距>2 mm时5 mm层厚较合适。
OBJECTIVE: To investigate the CT thickness of leukoplakia in malignant isolated pulmonary nodules. Methods: Forty-five patients with malignant solitary pulmonary nodules (diameter≤3 cm) underwent breath-hold training and 64-slice spiral CT chest scan (collimator width 0.625 mm × 64). Respectively, 1, 2, 5 mm and other three groups of images were compared, three groups of images of malignant isolated lung nodules showed similarities and differences. The 1 mm images of nodules and lobes as the standard analysis of malignant isolated pulmonary nodules leaves, 2,5 mm group of images to determine the reliability of malignant solitary pulmonary nodules sign. Results: A total of 98 lobes were found in 45 cases of malignant solitary pulmonary nodules at 1 mm. Among them, 25 were chord <1 mm, 30 were chord 1 ~ 2 mm and chord> 2 mm 43. The chord distance <1 mm on the 2 mm images showed that there were 18 identical leaves on the 1 mm images, with a significant difference (P = 0.023 <0.05). The chord at <1 mm on the 5 mm image shows 16 identical lobes to the 1 mm image, with a significant difference between the two (P = 0.004 <0.05). There were 24 consistent leaf segments on the 2 mm images with 1 ~ 2 mm chord on the 1 mm images. There was no significant difference between the 2 mm images (P = 0.261> 0.05). The chord length of 1 mm to 2 mm was displayed on the 5 mm images. There were 13 identical leaf segments on the 1 mm images. There was a significant difference between the two (P = 0.003 <0.05). There were 40 coincident segments displayed on the 2 mm images with chord> 2 mm and 1 mm. There was no significant difference between the two (P = 0.631> 0.05). There were 36 consistent leaf segments on the 5 mm image with chord> 2 mm. There was no significant difference in the number of leaf segments between the leaf and 1 mm images (P = 0.264> 0.05). Conclusions: The thickness of 1mm is suitable for malignant solitary pulmonary nodules when the chord distance is less than 1 mm, and 2 mm for chord 1 mm to 2 mm is appropriate.