Objective : To evaluate the diagnostic value of high resolution and enhanced spiral CT in small pulmonary solitary nodules (SPNs) . Methods : The plain, spiral and contrast enhanced CT data of 48 patients with SPNs less than 3 cm in diameter confirmed by parhology were retraspectively studied. among which 28 cases presented with peripheral lung cancer, with metastatic tumor, 5 with inflammatory masses of the lung, 4 with nodul tuberculoma. 2 with hamartoma. 2 with hemangioma. Results:The accurate rate of high resolutionen enhanced spiral CT for diagnosis 28 ISPNs was 90％. The mean value of enhanced CT with malignant SPNs and benign ones were 36 HU and 9 HU respectively. Most malignant SPNs showed homogeneous enhancement. the enhanced CT value was more than 20 HU. The benign ones were heterogeneous enhancement. The enhanced CT value was less than 10 HU. Conclusion: High resolution enhanced spiral CT examination makes it possible to distinguish malignant SPNs from benign ones in most situations. In the same time, we emphasize that the features of imaging morphology of SPNs, have important value in differentiating malignant SPNs from benign ones.%目的:评价HRCT扫描结合MSCT动态增强扫描在诊断肺内孤立性结节(SPNs)的价值.方法:收集直径小于3cm的肺内孤立性结节患者48例,其中周围型肺癌28例,单发转移瘤5例,肺炎性假瘤5例,结核瘤4例,肺血管瘤2例,支气管肺腺瘤2例、肺错构瘤2例.48例患者均先行常规胸部CT扫描,然后对兴趣区行HRCT扫描,然后行胸部动态增强扫描,并测量其CT值增强幅度.结果:HRCT扫描结合MSCT动态增强扫描诊断肺内孤立性小结节的正确率为90%,HRCT扫描可以更好显示病灶边缘特征及内部结构,动态增强扫描可见肺内恶性结节大多均匀增强,且增强CT值大于20HU,平均增强CT值为35HU,良性结节多周边增强,且增强CT值小于10HU,结论:根据SPNs的HRCT基本形态特征,并结合MSCT动态增强扫描强化特征有助于肺内孤立性结节的定性诊断,提高术前诊断正确率.
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