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目的：评价ＣＴ增强扫描鉴别诊断肺内孤立小结节的价值。材料与方法：直径８-２０ｍｍ肺内孤立小结节患者２６例：小肺癌１２例，灶性肺炎７例，结核结节４例，硬化性血管瘤１例，错构瘤２例．增强扫描前后均行薄层扫描（１．５－５ｍｍ层厚）．分别进行 ＣＴ平扫及 ＣＴ增强诊断的前瞻性对比研究结果： ＣＴ平扫诊断正确率为 ６５％， ＣＴ增强后诊断正确率为７７％，二者无显著差异。小肺癌、灶性肺炎及肺结核结节的平均增强ＣＴ值分别为４２Ｈｕ，３７Ｈｕ和３Ｈｕ。１例错构瘤和１例血管瘤因增强ＣＴ值大于４０Ｈｕ而误诊为肺癌。结论：ＣＴ增强对肺结核结节的诊断有帮助，肺癌和肺炎性病灶的ＣＴ增强鉴别诊断有困难。应强调以病灶基本形态为依据，增强ＣＴ对鉴别诊断有价值。１．０ｃｍ以下病灶的ＣＴ值测量不准确。
Objective: To evaluate the value of differential diagnosis of isolated small nodules in lung by CT enhanced scan. MATERIALS AND METHODS: Twenty-six patients with small nodules of 8-20 mm in diameter were diagnosed as small lung cancer in 12, focal pneumonia in 7, tuberculosis in 4, sclerosing hemangioma in 1 and hamartoma in 2. Enhanced scan before and after thin layer scanning (1.5-5mm layer thickness). The results of prospective comparative studies on CT scan and CT scan respectively: the accuracy of CT scan was 65%, and the accuracy of CT scan was 77%. There was no significant difference between the two methods. The average CT value of small lung cancer, focal pneumonia and pulmonary tuberculosis was 42Hu, 37Hu and 3Hu respectively. One case of hamartoma and one case of hemangioma were misdiagnosed as lung cancer because of enhanced CT value> 40Hu. Conclusion: CT enhancement is helpful to the diagnosis of pulmonary nodules. CT enhancement of lung cancer and pneumonia lesions is difficult to differentiate. Should be emphasized that the basis of the basic form of lesions, enhanced CT differential diagnosis is valuable. 1.0cm below the CT lesion inaccurate measurement.