摘要：目的 探讨螺旋CT动态增强扫描对肺孤立性结节病变的良、恶性鉴别诊断价值.方法 经病理证实的62例肺孤立性结节,平扫后,以2 ml/s速率注入造影剂后1、2、3、4、5 min薄层扫描.分析强化值、时间-密度曲线及强化形态对良、恶性结节的鉴别价值.结果 恶性结节的强化值(49±15)Hu明显高于良性结节(18±16)Hu(P＜0.01).周围型肺癌的主要强化形态是完全性强化及周围性强化.恶性结节增强后CT值立即升高,2 min形成强化高峰,然后逐渐下降,而良性结节特别是结核球增强后CT值缓慢上升,无明显峰值出现.结核球的主要强化形态是无强化及包膜样强化,占92.3%.结论 强化值≤15 Hu提示良性结节;强化值＞20 Hu考虑恶性结节.动态增强CT对周围型肺癌与结核球的鉴别有较高价值. Abstract： Objective To analyze the feature of the solitary pulmonary nodules at dynamic contrast-enhanced spiral CT. Methods Sixty-two patients with solitary pulmonary nodules proved by pathology were studied. Thin-section CT scans were obtained before and after enhancement 1,2,3,4 and 5 minutes. Results Malignant nodules enhanced (49±15)Hu significantly more than benign nodules (18±16)Hu. The major enhancement pattern of peripheral lung carcinoma was complete enhancement, a little show peripheral enhancement. Tuberculoma show capsular enhancement or non enhancement. Conclusions Absence of significant lung noldue enhancement (≤15 Hu) at CT is strongly predictive of benignity.Malignant nodules enhanced significantly more than benign nodules. Dynamic contrast enhanced CT is useful in the differential diagnosis of lung carcinoma and tuberculoma.

关键词：螺旋 平扫 动态增强扫描 肺孤立性结节 病变 

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