标题：肺内恶性孤立性小结节的CT征像特征分析

      作者：王群拴 1，李成业 2，梁海宇 1    (1.铜川市人民医院放射科，陕西 铜川 727000；2.铜川矿务局中心医院介入放射科，陕西 铜川 727000)

      卷次： 2018年29卷17期

      【摘要】 目的 观察肺内恶性孤立性小结节的CT征象，并分析CT对其诊断价值。方法 选择2015年6月至2016年12月期间铜川市人民医院诊治的肺恶性孤立性结节患者45例作为观察组，40例肺良性孤立性结节患者为对照组，所有患者均接受多层螺旋CT检查，观察良恶性肺结节形态学特征、强化曲线特征及CT值变化。结果 观察组和对照组患者的CT征象在肺结节存在浸润(62.2% vs 12.5%)、毛刺征(48.9% vs 32.5%)、胸膜凹陷征(77.8% vs25.0%)、分叶征(60.0% vs 37.5%)及集束征(55.6% vs 28.9%)方面比较差异均有统计学意义(P<0.05)；观察组患者的速升缓降型比例为64.4%，明显高于对照组的27.5%，低平缓型的比例为4.4%，明显低于对照组的52.5%，差异均有统计学意义(P<0.05)；观察组和对照组患者在肺结节强化值[(30.8±9.1) vs (16.9±5.4)]及增强峰值[(61.6±21.9) vs (45.3±16.2)]方面比较差异均有统计学意义(P<0.05)。结论 多层螺旋CT检查可以通过形态学特征及增强特征对肺内恶性孤立性结节进行诊断和鉴别诊断。
      【关键词】 孤立性结节；肺肿瘤；螺旋CT；肺癌
      【中图分类号】 R445 【文献标识码】 A 【文章编号】 1003—6350（2018）17—2446—03

Characteristic analysis of CT sign of malignant solitary pulmonary nodules.
WANG Qun-shuan 1, LI Cheng-ye 2,LIANG Hai-yu 1. 1. Department of Radiology, the People's Hospital of Tongchuan City, Tongchuan 727000, Shaanxi,CHINA; 2. Department of Interventional Radiology, the Central Hospital of Tongchuan Mining Bureau, Tongchuan 727000,Shaanxi, CHINA
【Abstract】 Objective To observe the CT signs of malignant solitary pulmonary nodules and analyze the CT di-agnostic value. Methods Forty-five patients with malignant solitary pulmonary nodules diagnosed and treated in thePeople's Hospital of Tongchuan City from June 2015 to December 2016 were selected as observation group, and 40 pa-tients with benign solitary pulmonary nodules were enrolled as control group. All patients underwent multi-slice spiralCT to observe the morphological features, enhancement curve characteristics and CT value changes of benign and malig-nant pulmonary nodules. Results The CT images of the observation group compared with the control group showed ob-vious abnormal signs in the pulmonary nodules: the rate of infiltration (62.2% vs 12.5% ), burrs sign rate (48.9% vs32.5%), pleural indentation rate (77.8% vs 25.0%), lobulated sign rate (60.0% vs 37.5%) and cluster sign rate (55.6% vs28.9%), respectively; all differences were statistically significant (P<0.05). The proportion of fast-rise-slow-fall type inthe observation group was significantly higher than that in the control group (64.4% vs 27.5%), and the proportion ofplatform type was significantly lower than that in the control group (4.4% vs 52.5%); both differences were statisticallysignificant (P<0.05). There were statistically significant differences in the enhancement values and peak enhancementvalues of pulmonary nodules between the observation group and the control group: (30.8±9.1) vs (16.9±5.4) and (61.6±21.9) vs (45.3±16.2), respectively, P<0.05. Conclusion Multi-slice spiral CT can be used for the diagnosis and differen-tial diagnosis of malignant solitary pulmonary nodules through morphological features and enhanced features.
      【Key words】 Solitary nodule; Lung tumor; Spiral CT; Lung cancer·论 著·doi:10.3969/j.issn.1003-6350.2018.17.023