Li Xin-yu, Zhang Xue-lin, Zhang Yu-zhong, Chen Bin, Whang Jian-ping, Shi Zhen
Diagnostic Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2009 Jan;29(1):133-6.
To assess the value of dynamic enhanced CT scanning in diagnosis of pulmonary nodules.
Sixty-nine patients with pulmonary nodules underwent examination with dynamic enhanced CT scanning. Of these patients, 53 with definite diagnoses confirmed by histological or clinical data were divided into three groups according to the nature of the nodules, namely the malignant group (n=34), benign group (n=13) and active inflammatory group (n=6). The time-density curve (T-DC) and the corresponding parameters of these patients were compared.
Significant differences in the net enhancement and S/A ratio were found among the 3 groups (P<0.001). The active inflammatory nodules showed the highest enhancement, followed by malignant nodules and then by benign nodules, with significant differences between any of the two groups (P<0.05). At the diagnostic threshold of net enhancement by 25 Hu or S/A ratio by 10% for malignant nodules, a higher negative predictive value and accuracy were obtained. The difference in the wash-out value among the 3 groups was statistically significant (P<0.05). When diagnostic criteria for malignancy was defined by a wash-in value of 25 Hu or higher and wash-out value of 0-35 Hu, the false-positive rate was decreased from 57.89% to 47.37%.
The application of 16-slice spiral CT and its CT perfusion software allows convenient dynamic enhancement study of pulmonary nodules and can be helpful in their differential diagnosis.
评估动态增强CT扫描在肺结节诊断中的价值。
69例肺结节患者接受了动态增强CT扫描检查。其中53例经组织学或临床资料确诊的患者，根据结节性质分为三组，即恶性组（n = 34）、良性组（n = 13）和活动性炎症组（n = 6）。比较这些患者的时间-密度曲线（T-DC）及相应参数。
三组间净强化值和S/A比值差异有统计学意义（P < 0.001）。活动性炎症结节强化程度最高，其次为恶性结节，良性结节强化程度最低，任意两组间差异均有统计学意义（P < 0.05）。以恶性结节净强化值25 Hu或S/A比值10%为诊断阈值时，阴性预测值和准确性较高。三组间廓清值差异有统计学意义（P < 0.05）。当以25 Hu及以上的强化值和0 - 35 Hu的廓清值作为恶性诊断标准时，假阳性率从57.89%降至47.37%。
16层螺旋CT及其CT灌注软件的应用可方便地对肺结节进行动态增强研究，有助于其鉴别诊断。
