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目的 探讨动态增强CT扫描对肺结核瘤的诊断价值。方法 经病理及临床证实的肺结核瘤 3 8例 ,平扫后 ,以 2ml/s速率注入造影剂后 1～ 5min薄层扫描。分析强化值、时间一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 3 8例结核瘤增强后扫描除 2例外 ,强化值均小于 2 0Hu ,与周围型肺癌、炎性假瘤对比均有显著性差异 (P <0 .0 1)。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 % ,完全性强化及周围性强化分别为 2例、1例。结核瘤的无强化区为干酪样坏死灶 ,结核瘤的不同强化形态取决于包膜的富血管、完整度及厚度。结核瘤的时间密度一曲线低平 ,无明显峰值。结论 结核瘤动态增强CT扫描在强化值、时间一密度曲线及强化形态均有一定特征 ,可与周围型肺癌及炎性肿块相鉴别。
Objective To investigate the diagnostic value of dynamic enhanced CT in the diagnosis of pulmonary tuberculosis. Methods Thirty-eight cases of tuberculoma confirmed by pathology and clinic were scanned by thin-layer scanning 1 ~ 5 min after injecting contrast agent at the rate of 2ml / s. Analyze fortified values, time-density curves and fortified forms. Correlation analysis of CT findings and vascularization. Results Forty-eight cases of tuberculoma enhanced scan except for 2 cases, the enhancement values were less than 20 Hu, compared with peripheral lung cancer, inflammatory pseudotumor were significant differences (P <0.01). The main enhancement form of tuberculoma was no enhancement and envelopment enhancement (19 cases and 16 cases, respectively), accounting for 92%. Complete consolidation and peripheral enhancement were 2 cases and 1 case, respectively. Tuberculous non-enhancement area is a caseous necrosis, and the different enhancement forms of tuberculoma depend on the vascularity, integrity and thickness of the capsule. The time density of tuberculoma curve a flat, no significant peak. Conclusion Dynamic enhanced CT scan of tuberculoma has some characteristics in enhancement value, time-density curve and enhanced morphology, which can be differentiated from peripheral type lung cancer and inflammatory mass.