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目的：探讨动态ＣＴ对肺内孤立性结节的诊断价值。方法：３５例直径６～４０ｍｍ的肺内孤立性结节，其中１９例肺癌，１２例结核球，２例炎性肉芽肿，２例错构瘤。对肺内孤立性结节进行薄层平扫后，以１．５ｍｌ／ｓ肘静脉注射碘对比剂后３０ｓ、２ｍｉｎ及５ｍｉｎ于相同二个中心层面进行动态增强扫描，计算结节最大强化ＣＴ值，描绘结节的时间—密度曲线，分析结节的强化类型。结果：全部肺癌和炎性肉芽肿显著增强，结核球无明显增强（Ｐ＜０．０１）。肺癌的时间—密度曲线表现逐渐升高，且大多数肺癌强化的峰值在注射对比剂后５ｍｉｎ，与良性结节明显不同。全部肺癌、错构瘤、结核球和炎性肉芽肿各例表现完全强化型，１例错构瘤和６例结核球表现无强化型，５例结核球表现边缘环状强化型，１例炎性肉芽肿表现周围强化型。结论：最大强化ＣＴ值＞２０ＨＵ的结节提示肺癌和少数活动性良性结节，无强化和／或边缘环状强化的结节提示结核球。
Objective: To investigate the value of dynamic CT in the diagnosis of solitary pulmonary nodules. Methods: Thirty-five patients with solitary pulmonary nodules of 6 ~ 40 mm in diameter were involved, of which 19 were lung cancer, 12 were tuberculomas, 2 were inflammatory granulomas and 2 were hamartomas. Thoracic solitary pulmonary nodules after thinning, injection of 1.5ml / s elbow vein iodine contrast agent 30s, 2min and 5min in the same two central level dynamic enhancement scan to calculate the maximum nodule enhancement CT value , Plotting the time-density curve of the nodule and analyzing the enhancement type of the nodule. Results: All of lung cancer and inflammatory granuloma were significantly increased, but there was no significant increase in tuberculoma (P <0.01). Lung cancer time-density curve performance gradually increased, and most of the peak intensity of lung cancer contrast injection 5min, significantly different from benign nodules. All cases of lung cancer, hamartoma, tuberculoma and inflammatory granuloma cases showed complete enhancement, 1 case of hamartoma and 6 cases of tuberculoma showed no enhancement, 5 cases of tuberculoma showed edge ring-enhanced, 1 case of inflammation Sexual granulomas around the enhanced type. CONCLUSION: Nodules with maximally enhanced CT values> 20HU suggest lung cancer and a few active benign nodules, suggesting that nodules without enhancement and / or edge ring enhancement suggest tuberculoma.