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目的探讨双排螺旋CT灌注成像在孤立性外周肺结节良性、炎性、恶性的诊断及鉴别诊断的意义。方法利用双排螺旋CT灌注成像技术研究50例直径2～5cm的孤立性外周肺结节灌注表现,采用CTperfusion胸部肿瘤灌注软件包,测定肺内病灶的血容量(BV)、血流量(BF)、对比剂到达峰值的时间(TTP)、强化峰值(PEI)和时间-密度曲线(TDC),并在其基础上计算出强化值、孤立性外周肺结节与主动脉增强峰值之比值(S/A)。结果恶性结节和炎性结节的BF、BV和PEI值均明显高于良性结节(P<0.05),恶性结节和炎性结节之间的灌注值则差异无统计学意义(P>0.05),恶性结节、良性结节和炎性结节的时间-密度曲线(TDC)均显示形态不同。恶性结节和炎性结节强化值、S/A值高于良性结节(P<0.05)。结论双排螺旋CT灌注成像有助与良恶性肺结节的诊断及鉴别诊断。
Objective To investigate the value of double-helical CT perfusion imaging in the diagnosis and differential diagnosis of benign, inflammatory and malignant solitary pulmonary nodules. Methods Fifty patients with solitary pulmonary nodules of 2 to 5 cm in diameter were studied by double-perfusion spiral CT perfusion imaging. The volume of blood (BV), blood flow (BF) (TTP), PEI and TDC, and calculated the intensified value based on which the ratio of isolated peripheral nodules to aortic enhancement peak (S / A). Results The BF, BV and PEI values of malignant and inflammatory nodules were significantly higher than those of benign nodules (P <0.05), but there was no significant difference between malignant nodules and inflammatory nodules (P > 0.05). The time-density curves (TDC) of malignant nodules, benign nodules and inflammatory nodules all showed different morphologies. Malignant nodules and inflammatory nodules enhanced value, S / A value higher than benign nodules (P <0.05). Conclusion Double-perfusion CT perfusion imaging is helpful for the diagnosis and differential diagnosis of benign and malignant pulmonary nodules.