多层螺旋CT对肺内孤立性结节的诊断分析doi:10.3969/j.issn.1007-614x.2014.3.58摘要目的:探讨多层螺旋CT对诊断肺内孤立性结节的应用价值。方法:收治肺内孤立性结节患者80例,采用多层螺旋CT进行扫描检查。结果:CT征象为“三角形”影及阻塞性炎性反应,其中周围型肺癌20例,占44.4%,炎性结节6例,占17.1%;CT征象为“晕圈征”,其中周围型肺癌9例,占20.0%,炎性结节15例,占42.9%;CT征象为“短毛刺”,其中周围型肺癌25例,占55.6%,炎性结节3例,占8.6%;CT征象为“长毛刺”,其中周围型肺癌9例,占20.0%,炎性结节23例,占65.7%;CT征象为“恶性胸膜凹陷征”,其中周围型肺癌27例,占60.0%,炎性结节3例,占8.6%;CT征象为“良性胸膜凹陷征”,其中周围型肺癌11例,占24.4%,炎性结节18例,占51.4%;CT征象为肿块边缘“深分叶”,其中周围型肺癌25例,占71.4%,炎性结节14例,占40.0%;CT征象为肿块边缘呈“刀切样”或者“方形”,其中周围型肺癌14例,占31.1%,炎性结节21例,占60.0%。两组比较差异有统计学意义(P〈0・05)。结论:“三角形”影及阻塞性炎性反应、“晕圈征”、“短毛刺”、“长毛刺”、“恶性胸膜凹陷征”、“良性胸膜凹陷征”、肿块边缘“深分叶”、肿块边缘呈“刀切样”或者“方形”是鉴别周围型肺癌和肺炎性结节的关键。关键词CT征象周围型肺癌肺炎性结节ThediagnosisanalysisofsolitarypulmonarynodulebymultisliceCTChenSizhengPeople'sHospitalofYongcheng,HenanProvince,476600AbstractObjective:Toinvestigatethevalueofmulti-slicespiralCTinthediagnosisofsolitarypulmonarynodules.Method:August2011〜July2013solitarypulmonarynodulestreated80patients,theuseofmulti-slicespiralCTsean.Results:CTsignsandblockinginflannnatiorbincluding20cancer(44.4%),inflammatorynodulesin17.1%,CTsignsof"halo"sign,whichcases(20.0%),15casesofinflammatorynodules,accountingfor42.9%,CTsignsof"shortglitches"inwhichperipherallungcancer,25cases(55.6%),inflammatorynodulesin3cases,accountingfor8.6%,CTsigns"longglitch"inwhichninecasesofperipherallungcancer,accountingfor20.0%ofinflammatorynodulesin23cases,accountingfor65.7%,CTsignsof/zmalignantpleuralindentation^,where27casesofperipherallungcancer,accountingfor60.0%,inflammationnodulesthreecases,accountingfor8.6%,CTsignsof〃benignpleuralindentation,"where11casesofperipherallungcancer,accountingfor24.4%ofinflammatorynodulesin18cases,accountingfor51.4%,CTsignsoftumoredge"deeppointsleaf"inwhich25casesofperipherallungcancer,accountingfor71.4%ofinflammatorynodulesin14cases,accountingfor40.0%,CTshowedsignsoftumoredge"knife-like"or"square",where14casesofperipherallungcancer,accountingfor31.1%inflammatorynodulesin21cases,accountingfor60.0%,morerestrictivedifferences(PKeywordsCTsigns;Peripherallungcancer;Inflammatorynodules肺内孤立性结节是CT检查过程中常见的征象,由于引起需肺内孤立性结节的疾病较多,需要进一步鉴别诊断,为讨多层螺旋CT在诊断肺内孤立性结节的应用价值,2011年8月-2013年7月收治肺内孤立性结节患者80例,进行回顾性分析,ofthez/triangle/zshadowcasesofperipherallung6cases,accountingforperipherallungcancer9现报告如下。资料与方法一般资料:2011年8月-2013年7月收治肺内孤立性结节患者80例,其中男56例,女24例,年龄26~79岁,平均45.6岁。病理检查结果:肺炎性结节35例,周围型肺癌45例。方法:采用多层螺旋CT,常规扫描:层厚10mm,层距10mm;病灶加薄层扫描,层厚2.5〜5mnb层距2.5~5mm,扫描电压120kV,电流225mA,螺旋扫描:层厚1.5mm,螺距0.7mm,高分辨扫描:层厚1.0mm,1024X1024骨算法。研究方法:①通过对病灶的薄层扫描,显示“病灶边缘的形态3包括“刀切样”,“方形”改变和“深分叶”;②通过高分辨扫描并在肺窗下观察“毛刺征S“长毛刺”即毛刺长度大于5mm;“短毛刺”即毛刺长度小于或等于5mm;③通过螺...