CT动态增强扫描在周围型小肺癌中的诊断价值研究(1)
[摘要] 目的 探讨CT动态增强扫描在周围型小肺癌中的诊断价值。方法 随机选取2013年1月—2015年6月间海安县中医院放射科检查的70例经胸部X线摄片疑诊的周围型小肺癌患者作为研究对象，分别采用CT平扫和增强动态增强扫描，对其图像特征和肺肿块血流动力学进行分析和比较，总结研究其临床检查价值。结果 两组在肿瘤确诊率、肿块边界区分率、肺不张和纵膈淋巴结肿大发现率等比较，χ2值分别为2.429，2.374，3.718和2.751，差异有统计学意义(P<0.05)；良恶性肿瘤感兴趣区血流量(BF)、血容量(BV)、平均通过时间(MTT)和表面通透性(PS)等肿瘤血流动力学指标方面比较，t值分别为2.429，2.374，3.718和2.751，差异有统计学意义(P<0.05)。 结论 使用CT动态增强扫描诊断周围型小肺癌，能显著提高小肺癌的确诊率，清晰显示肿瘤周边情况和血流动力学指标，为早期诊断、肿瘤分期和临床治疗，具有准确而重要的指导价值。
[关键词] 周围型小肺癌；CT检查；动态增强扫描；诊断价值；研究
[中图分类号] R734.2 [文献标识码] A [文章编号] 1674-0742(2015)12(c)-0185-03
Research on Diagnostic Value of CT Dynamic Contrast-enhanced Scan in the Peripheral Small lung Carcinoma
XU Ai-jun
Department of radiology， Haian Hospital of traditional Chinese Medicine， Nantong， Jiangsu Province， 226600 China
[Abstract] Objective To discuss the diagnostic value and research experience of CT dynamic contrast-enhanced scan in the peripheral small lung carcinoma. Methods 70 cases of patients suspected with peripheral small lung carcinoma by chest x-ray and examined in the department of radiology in Haian Hospital of traditional Chinese Medicine from January 2013 to June 2015 were selected as the research object and were respectively given CT non-contrast enhanced scan and CT dynamic contrast-enhanced scan， and the image characteristics and lung mass hemodynamics of them were analyzed and compared， the clinical examination values were summarized and researched. Results The differences in the diagnostic rate of tumors， mass boundary resolution， discovery rates of atelectasis and mediastina lymphadenectasis of the two groups were obvious(χ2=2.429， 2.374， 3.718 and 2.751)(P<0.05)，the differences in the tumor hemodynamics indexes such as blood flow， blood volume， mean transit time and permeability surface in the region of interest of benign and malignant tumors were obvious (t= 2.429， 2.374， 3.718 and 2.751) (P<0.05). Conclusion CT dynamic contrast-enhanced scan in diagnosis of peripheral small lung carcinoma can obviously improve the diagnostic rate of small lung carcinoma and clearly revealed the tumor periphery and hemodynamics indexes， which can provide powerful basis for early diagnosis and tumor staging and provide reliable guidance for the clinical early treatment and judging the prognosis.
[Key words] Peripheral small lung carcinoma； CT examination； Dynamic contrast-enhanced scan； Diagnostic value； Research
肺癌是呼吸系统最常见的恶性肿瘤，发生于支气管粘膜上皮，大部分患者确诊时已处于中晚期，早期诊断显得极为重要[1]。CT可发现肿瘤所在的部位和累及范围，对区分良恶性和临床分期具有较高的诊断价值，是目前最有价值的无创检查手段。小肺癌是直径小于3.0 cm的肺癌，以周围型腺癌居多，因肿瘤瘤体的密度较低，早期CT影像图常不能清晰显示肿瘤的边缘、肺门、纵膈淋巴结侵犯情况和血流动力学指标，给早期诊断带来一定的困难[2]。随着医疗科技的快速发展，使用CT动态增强扫描可以提高小肺癌的早期诊断率，为临床诊疗提供重要的指导价值。该研究对2013年1月—2015年6月海安县中医院放射科采用CT动态增强扫描检查的70例周围型小肺癌，取得了较好的效果，现进行分析讨论，现报道如下。 (许爱军)
[关键词] 周围型小肺癌；CT检查；动态增强扫描；诊断价值；研究
[中图分类号] R734.2 [文献标识码] A [文章编号] 1674-0742(2015)12(c)-0185-03
Research on Diagnostic Value of CT Dynamic Contrast-enhanced Scan in the Peripheral Small lung Carcinoma
XU Ai-jun
Department of radiology， Haian Hospital of traditional Chinese Medicine， Nantong， Jiangsu Province， 226600 China
[Abstract] Objective To discuss the diagnostic value and research experience of CT dynamic contrast-enhanced scan in the peripheral small lung carcinoma. Methods 70 cases of patients suspected with peripheral small lung carcinoma by chest x-ray and examined in the department of radiology in Haian Hospital of traditional Chinese Medicine from January 2013 to June 2015 were selected as the research object and were respectively given CT non-contrast enhanced scan and CT dynamic contrast-enhanced scan， and the image characteristics and lung mass hemodynamics of them were analyzed and compared， the clinical examination values were summarized and researched. Results The differences in the diagnostic rate of tumors， mass boundary resolution， discovery rates of atelectasis and mediastina lymphadenectasis of the two groups were obvious(χ2=2.429， 2.374， 3.718 and 2.751)(P<0.05)，the differences in the tumor hemodynamics indexes such as blood flow， blood volume， mean transit time and permeability surface in the region of interest of benign and malignant tumors were obvious (t= 2.429， 2.374， 3.718 and 2.751) (P<0.05). Conclusion CT dynamic contrast-enhanced scan in diagnosis of peripheral small lung carcinoma can obviously improve the diagnostic rate of small lung carcinoma and clearly revealed the tumor periphery and hemodynamics indexes， which can provide powerful basis for early diagnosis and tumor staging and provide reliable guidance for the clinical early treatment and judging the prognosis.
[Key words] Peripheral small lung carcinoma； CT examination； Dynamic contrast-enhanced scan； Diagnostic value； Research
肺癌是呼吸系统最常见的恶性肿瘤，发生于支气管粘膜上皮，大部分患者确诊时已处于中晚期，早期诊断显得极为重要[1]。CT可发现肿瘤所在的部位和累及范围，对区分良恶性和临床分期具有较高的诊断价值，是目前最有价值的无创检查手段。小肺癌是直径小于3.0 cm的肺癌，以周围型腺癌居多，因肿瘤瘤体的密度较低，早期CT影像图常不能清晰显示肿瘤的边缘、肺门、纵膈淋巴结侵犯情况和血流动力学指标，给早期诊断带来一定的困难[2]。随着医疗科技的快速发展，使用CT动态增强扫描可以提高小肺癌的早期诊断率，为临床诊疗提供重要的指导价值。该研究对2013年1月—2015年6月海安县中医院放射科采用CT动态增强扫描检查的70例周围型小肺癌，取得了较好的效果，现进行分析讨论，现报道如下。 (许爱军)