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目的 探讨良恶性孤立性肺结节(solitary pulmonary nodule,SPN)的增强CT表现及鉴别诊断价值。方法 对75例经手术、病理证实的SPN患者的CT图象进行回顾性分析,其中恶性肿瘤59例,良性肿瘤8例,肉芽肿8例。所用CT为Siemens SomatomPlus,采用病灶中心层面同床位动态扫描模式,测注射造影剂前后相同层面的CT值,以30Hu作为结节造影后有强化的下限。结果 本组中无强化9例,有强化66例。按强化程度分:轻度强化35例,中度强化27例,显著强化4例;按强化形态分:均匀强化38例,不均匀强化21例,周边强化7例;按病变性质分:恶性肿瘤多呈轻。中度均匀或不均匀强化,肺腺瘤和炎性假瘤多呈中度均匀强化,肺错构瘤和结核瘤多元强化或仅是边缘强化,肺血管瘤(包括动静脉畸形)表现为显著均匀强化。结论 良恶性SPN因部位、大小、血供及细胞类型等的差异而呈现不同的强化特征。
Objective To investigate the enhanced CT findings and differential diagnosis of benign and malignant solitary pulmonary nodules (SPNs). Methods A retrospective analysis was performed on CT images of 75 patients with SPN confirmed by operation and pathology. Among them, 59 were malignant tumors, 8 were benign tumors and 8 were granulomas. CT used for the Siemens SomatomPlus, the lesion center level with the bed dynamic scanning mode, before and after injection of contrast agent measured the same level of CT value to 30Hu as nodules with enhanced lower limit. Results There was no enhancement in this group in 9 cases, with enhancement in 66 cases. According to the degree of enhancement, there were 35 cases with mild enhancement, 27 cases with moderate enhancement, and 4 cases with marked enhancement. According to the enhancement patterns, 38 cases were homogenized, 21 cases were non-uniformly enhanced and 7 cases were peripheral enhanced. Mostly light. Moderate or uneven enhancement of lung adenoma and inflammatory pseudotumor were moderately homogeneous enhancement of pulmonary hamartoma and tuberculosis multiple enhancement or only edge enhancement, pulmonary hemangioma (including arteriovenous malformations) showed significant Even strengthen. Conclusion The benign and malignant SPN showed different enhancement features due to the difference of site, size, blood supply and cell types.