多排螺旋CT(MSCT)动态增强对孤立性肺结节血流模式的评价

摘要

Objective: To evaluate the efficacy of dynamic multi-slice spiral computed tomography (MSCT)for providing quantitative information about blood flow patterns of solitary pulmonary nodules (SPNs)and differentiating solitary pulmonary nodules (SPNs). Methods: 37 patients with SPNs (diameter≤4cm; 24 with maliagnant; 6 with benign; 7 with inflammatory) underwent multi-location dynamic contrast material-enhanced (90 mL, 4 mL/s) serial CT. Peak height and ratio of peak height of the SPN to that of the aorta were measured. Precontrast attenuation was recorded. Perfusion was calculated from the maximum gradient of the time-attenuation curve and the peak height of the aorta. Results: Peak heights of malignant (37.98 HU±17.97) and inflammatory (43.86 HU±14.20) SPNs were significantly higher than those of benign SPNs (5.65 HU±6.43) (P＜0.001; P＜0.001). No statistically significant difference in the peak height was found between malignant and inflammatory SPNs (P=0.647＞0.01). SPN-to-aorta ratio in inflammatory SPNs (20.78%±4.14) was significantly higher than that in benign (2.00%±2.26) and malignant (14.63%±6.22) SPNs (P＜0.001; P=0.021＜0.05). SPN-to-aorta ratio in malignant SPNs was significantly higher than that in benign SPNs (P＜0.001). Perfusion value in inflammatory SPNs [78.39 mL/(min.100g)±55.18] was significantly higher than that of benign [2.13 mL/(min.100g)±2.84] and malignant [33.91mL/(min.100g)±15.58] SPNs (P＜0.001; P=0.001＜0.01). Perfusion value in malignant SPNs was significantly higher than that in benign SPNs (P＜0.001). Precontrast attenuations of inflammatory (39.36HU±9.57)and benign (37.73 HU±8.39) SPNs were lower than that of malignant SPNs (45.73 HU±4.21)(P=0.04＜0.05; P=0.014＜0.05). No statistically significant difference in the precontrast attenuation was found between benign and inflammatory SPNs (P=0.836＞0.01). Conclusion: MSCT provides quantitative information about blood flow patterns of solitary pulmonary nodules (SPNs) and is applicable diagnostic method for differentiating SPNs.