【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78例肺孤立性结节，平扫后，以2ml/s速率注入造影剂后1、2、3、4、5min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(38.6±14.9)HU明显高于良性结节(18.5±16.4)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,2min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≤15HU提示良性结节；强化值>20HU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。

    【关键词】 肺结节；螺旋CT；动态增强

    Dynamic contrast-enhanced spiral CT in differentiation of the solitary pulmonary nodule

    LIU Jin-kang,XIA Yu,YIN Dan.

    Xiangya Hospital,Central South University,Changsha 410008,China

    【Abstract】 Objective To analyze the feature of the solitary pulmonary nodules at dynamic contrast-enhanced spiral CT.Methods 78 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 (38.6±14.9)HU significantly more than benign nodules (18.5±16.4)HU.The major enhancement pattern of peripheral lung carcinoma was complete enhancement,a little show peripheral enhancement.Tuberculoma show capsular enhancement or non enhancement.Conclusion 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 differentiation diagnosis of lung carcinoma and tuberculoma. ......