多层螺旋CT的动态增强扫描对胸部孤立性结节的诊断价值
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The Diagnostic value of dynamic enhanced multi-slice spiral CT in solitary pulmonary nodules
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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5 ml/s和3 ml/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20~60 Hu之间,20%(5/25) > 60 Hu或 < 20 Hu-增强峰值和峰值时间分别为(31.31 ± 10.62)Hu-45 s-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 > 40 Hu-增强峰值(49.25 ± 12.44)Hu,峰值时间为80 s和140 s-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-

    Abstract:

    Objective:To evaluate the clinical value of dynamic enhanced multi-slice spiral computed tomography(MSCT) in solitary pulmonary nodules(SPN). Methods:40 SPN(25 malignant nodules, 8 inflammatory nodules, and 7 benign nodules) were scanned firstly to determine the nodules range and then scanned through the center of them after contrast media were performed with 5 ml/s or 3 ml/s. The pre-and post-contrast density, peak height after enhanced(PH) and peak time(PT) of SPN were recorded. Results: Moderate enhancement appeared mostly in lung carcinoma and the increased CT density varied from 20 to 60 Hu in 20/25 cases(80%). Peak height of lung cancer was(31.31 ± 10.62)Hu, peak time was 45 s, and the time-density curve represent slowly uptrend. Marked enhancement appeared mostly in inflammatory nodules,and the increased CT density was morn than 40 Hu. Peak height of inflammatory nodules was(49.25 ± 12.44)Hu, and peak time was 80 and 140 s. The curve’s trend of enhancement was wavy. Conclusion:Dynamic contrast enhanced CT can reflect the hemodynamic characteristic of SPN and be used non-invasively in the evaluation of solitary pulmonary nodules.

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陈瑜凤,夏淦林,冯 峰,施冬辉.多层螺旋CT的动态增强扫描对胸部孤立性结节的诊断价值[J].南京医科大学学报(自然科学版),2008,28(10):1328-1331

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