目的：探讨多层螺旋CT 动态增强扫描成像在良恶性孤立性肺结节定性鉴别的应用价值，提高疾病诊断的准确性。方法：回顾分析68例孤立性肺结节（SPN）患者的临床病例资料，所有患者采用多层螺旋 CT 扫描机对 SPN 行平扫和增强后序列扫描，计算结节增强参数，统计各个期相的CT 净增值与最大CT 净增值的差异，观察结节形态学征象，计算多期动态扫描的△CT 值对诊断恶性与非恶性SPN的敏感性、特异性、准确性。结果：炎性、恶性SPN 增强后30s、60s、120s、180s、240s、300s的 CT 值均明显高于良性SPN ，炎性SPN 增强后60s、120s、180s、240s、300s的CT 值明显高于恶性SPN ，因而，炎性SPN 强化最明显，恶性次之，良性强化最不明显，三者之间有统计学意义。结论：多层螺旋CT 动态增强扫描成像能够为恶性、良性、炎性SPN 鉴别提供有利证据，可以同时观察结节的形态和强化特征。%Objective:To investigate the application value of multi‐slice spiral CT with dynamic enhanced dynamic scan in the qualitative identification of benignancy and malignancy of pulmonary nodule ,so as to im‐prove veracity when diagnosing diseases .Methods:The clinical data of 68 cases of SPN patients were analyzed retrospectively .Scan all the patients SPN routinely with multi‐slice spiral CT scanner and in sequence after the it has been enhanced .Calculate the enhanced parameters of nodules .Make statistics for the differences between the net added value and the maximum net added value of CT in each phase ,observe the morphologi‐cal signs of nodules ,calculate the sensibility ,specificity and veracity of the value of △CT of multi‐phase dy‐namic scanning in respect to the diagnosis of malignant and non‐ malignant nodules .Results:After the in‐flamed and malignant SPN has been enhanced for 30s ,60s ,120s ,180s ,240s ,300s ,the value of CT were obvi‐ously higher than that of the benign SPN ,after the inflame SPN had been enhanced for 30s ,60s ,120s ,180s , 240s ,300s ,the value of CT were obviously higher than that of malignant SPN ,thus the enhancement of in‐flamed SPN was the most obvious of all ,and that of the malignant took the second place and that of the be‐nign was the least obvious ,and the differences among the three were statistically significant .Conclusion:Multi‐slice spiral CT with dynamic enhanced dynamic scanning can provide favorable evidences for the identi‐fication of malignant ,benign and inflamed SPN and the morphology and the enhanced signs of nodules can al‐so be observed as w ell .
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