CT及MRI在孤立性肺结节性质鉴别中的应用

摘要

目的：探讨CT及MRI在孤立性肺结节(SPN)性质鉴别中的应用价值。方法回顾性分析2013年6月—2015年6月医院72例经穿刺活检或手术病理确诊为SPN患者的CT及MRI影像学资料。结果以临床病理为“金标准”,CT诊断孤立性肺结节的准确性、敏感性、特异性分别为83.33%、85.71%、78.26%,MRI诊断孤立性肺结节的准确性、敏感性、特异性分别为79.17%、91.63%、73.91%,两组比较差异无统计学意义(P>0.05)。 CT上部分恶性结节有深分叶征、棘突或毛刺征、血管集中征、胸膜凹陷征、钙化征,增强扫描肿块明显均匀强化,CT净增值高于20HU；良性结节仅少部分有肿块影、病灶内钙化,增强扫描为轻度强化,CT净增值低于20HU。MRI诊断显示, T1WI略低或等信号,T2WI略高信号,脂肪抑制序列为略高信号,部分有分叶征、毛刺征、胸膜凹陷征,增强扫描可见中度明显强化；良性结节为T1W1略低信号或混杂信号,T2WI略高信号或混杂信号。结论 CT、MRI诊断孤立性肺结节具有一定特征性表现,在鉴别诊断结节良恶性中有一定价值。%Objective To explore the application value of CT and MRI in the identification of solitary pulmonary nod-ules (SPN). Methods The CT and MRI data of 72 patients with SPN diagnosed by biopsy or surgical pathology in the hospital between June 2013 and June 2015 were analyzed retrospectively. Results With clinical pathology as the golden standard, the accuracy, sensitivity and specificity of CT in the diagnosis of SPN were 83.33%, 85.71%and 78.26% re-spectively while of MRI were 79.17%, 91.63%and 73.91%, respectively. However, there were no significant differences (P > 0.05). CT showed that upper malignant nodules were with deep lobulation sign, spinous process or spicule sign, concentrated vascular sign, pleural indentation sign and calcification sign. Enhanced scan showed that the masses were significantly enhanced, and CT net value was higher than 20HU; Only a small part of benign nodules were with mass shadow and calcification within the lesions. Enhanced scan showed mild enhancement, and CT net value was less than 20HU. MRI diagnosis showed slightly low or equal signals on T1WI, slightly higher signal on T2WI and slightly higher signal on fat suppression sequence. Some were with lobulation sign, spicule sign and pleural indentation sign. Enhanced scan showed moderate significantly enhancement;Benign nodules showed slightly lower signal or mixed signal on T1WI and slightly higher signal or mixed signal on T2W1. Conclusion CT and MRI have certain characteristics in diagnosis of solitary pulmonary nodules. They are of certain value in the differential diagnosis of benign and malignant nodules.