【摘要】 背景与目的:肺癌、肺结核球和炎性假瘤是最常见的孤立性肺结节(solitarypulmonarynodule,SPN),CT(computedtomography)是最主要的诊断方法,近年来关于它们的CT特征报道较多,但绝大多数都是从形态学上的分析,鉴别诊断较困难,本研究旨在观察肺癌、肺结核球和炎性假瘤的血供变化,找出它们的一些特征和规律,为诊断和鉴别诊断提供更多信息。方法:采用螺旋CT对115例肺部单个结节进行动态增强扫描,总结分析经手术治疗确诊病例44例,其中肺癌30例,肺结核球7例,肺炎性假瘤7例。结果:30例肺癌中轻度强化2例,中度强化14例,高度强化5例,显著高度强化2例,无强化7例。肺癌最高强化值开始出现在18～28s9例,30～39s17例,40～44s4例,平均32s。7例结核球中5例无强化,2例环状强化。7例炎性假瘤均呈显著高度强化,最高强化值均在100Hu以上,最高强化值出现的时间分别为26s、28s、30s、32s、33s、110s和122s。结论:螺旋CT动态增强扫描对肺癌、肺结核球、炎性假瘤的鉴别诊断有一定的帮助。更多还原

【Abstract】 BACKGROUND & OBJECTIVE: Lung carcinoma, pulmonary tuberculoma, and inflammatory pesudotumor are the most common solitary pulmonary nodules (SPN). Computed tomography (CT) is the major diagnostic examination of them. Most recent reports focused on their morphologic features on CT. The differential diagnoses are still difficult. This study was to explore their imaging features on helical incremental dynamic CT scan according to the differences of their hematal supply, and get more information for the diagnosis and differential diagnosis. METHODS: Incremental dynamic CT scan was performed on 115 cases of solitary pulmonary nodule. Of the 44 cases proved by postoperative pathology, 30 were lung carcinoma, 7 were pulmonary tuberculoma, and 7 were inflammatory pesudotumor. RESULTS: Of the 30 cases of lung carcinoma, 7 were mildly enhanced, 14 were moderately enhanced, 5 were highly enhanced, 2 were remarkably enhanced, and 7 were not enhanced; 9 had peak enhancement began at 18-28 s after injection, 17 began at 30-39 s, and 4 began at 40-44 s, with an average time of 32 s. Of the 7 cases of tuberculoma, 5 were not enhanced, and 2 were cricoid enhanced. All the 7 cases of inflammatory pesudotumor were remarkably enhanced, with the peak enhancement value of over 100 Hu in all cases; the peak enhancements began at 26 s, 28 s, 30 s, 32 s, 33 s, 110 s, and 122 s, respectively, after injection. CONCLUSION: Helical incremental dynamic CT is helpful in differential diagnoses of lung carcinoma, pulmonary tuberculoma, and inflammatory pesudotumor.更多还原