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目的探讨孤立性肺结节病灶动态增强扫描的强化程度与动态强化曲线及其机理。资料与方法对经手术、病理证实的孤立性肺结节病患者40例,行前瞻性螺旋CT动态增强扫描,分析最大强化值及时间密度曲线。并对20例手术标本行CD34染色。结果恶性结节的强化(范围16～76HU)明显高于良性结节(范围-6～46HU,P<0.01)。以强化值15HU为阈值,敏感性100%(27/27例恶性结节),特异性46.2%(6/13例良性结节),准确性82.5%(33/40例肺结节)。结节的强化程度与结节中央微血管数呈正相关(P=0.006)。结论强化值≤15HU,提示为良性结节;恶性结节较良性结节更富血管,其强化程度也明显高于良性结节。炎性假瘤是产生假阳性的主要原因,动态曲线分析对其与恶性结节的鉴别有一定帮助。
Objective To investigate the degree of enhancement and dynamic enhancement curve of dynamic enhanced scanning in solitary pulmonary nodules and its mechanism. Materials and Methods Forty patients with solitary pulmonary sarcoidosis confirmed by operation and pathology underwent dynamic contrast-enhanced scanning with prospective spiral CT, and analyzed the maximum enhancement value and time density curve. And 20 cases of surgical specimens CD34 staining. Results The enhancement of malignant nodules (range 16 ~ 76HU) was significantly higher than that of benign nodules (range -6 ~ 46HU, P <0.01). The sensitivity was 100% (27/27 malignant nodules), the specificity was 46.2% (6/13 benign nodules), and the accuracy was 82.5% (33/40 pulmonary nodules). The degree of enhancement of nodules was positively correlated with the number of central nodules in the nodules (P = 0.006). Conclusion The enhanced value is ≤ 15HU, suggesting benign nodules. Malignant nodules are more vascular than benign nodules, and their enhancement degree is also significantly higher than that of benign nodules. Inflammatory pseudotumor is the main cause of false positive, dynamic curve analysis of malignant nodules with some help.