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目的:研究多层螺旋CT(MSCT)动态增强扫描对胸部孤立性结节(SPN)的定性价值。方法:对40例胸部结节(其中恶性结节25例,炎性结节8例,良性结节7例)先平扫确定结节范围。以5ml/s和3ml/s两种速率分别在结节中心层面行CT动态增强扫描,记录SPN增强前后的CT值、强化峰值(PH)和峰值时间(PT),结果:恶性结节以中等强化为主,净增值80%(20/25)在20～60Hu之间,20%(5/25)>60Hu或<20Hu。增强峰值和峰值时间分别为(31.31±10.62)Hu、45s。时间-密度曲线(T-DC)呈缓慢升高型;炎性结节呈重度强化为主,净增值均>40Hu。增强峰值(49.25±12.44)Hu,峰值时间为80s和140s。曲线中出现上升后下降又上升的特点。结论:多层螺旋CT动态增强扫描反映胸部结节血流的动力学特性,可无创性评价和诊断SPN。
Objective: To study the qualitative value of dynamic contrast-enhanced multislice spiral CT (MSCT) in the diagnosis of solitary pulmonary nodules (SPN). Methods: Forty cases of thoracic nodules (including 25 malignant nodules, 8 inflammatory nodules and 7 benign nodules) were scanned to determine the extent of nodules. CT dynamic enhancement scanning at the center of nodules was performed at 5ml / s and 3ml / s respectively. The CT value, enhanced peak value (PH) and peak time (PT) before and after SPN enhancement were recorded. Results: Malignant nodules were moderately Intensified, the net increase of 80% (20/25) in 20 ~ 60Hu, 20% (5/25)> 60Hu or <20Hu. Enhancement peak and peak time were (31.31 ± 10.62) Hu, 45s. The time-density curve (T-DC) showed a slowly increasing type; the inflammatory nodules were mainly intensified and the net added value was> 40Hu. The enhancement peak (49.25 ± 12.44) Hu, the peak time was 80s and 140s. The curve appears to rise and then fall and rise. Conclusions: Multi-slice spiral CT dynamic enhanced scan reflects the dynamic characteristics of the thoracic nodule blood flow, which can evaluate and diagnose SPN noninvasively.