摘要:
目的: 探讨肺部结节三维重建的应用价值。材料与方法:常规扫描采用螺旋扫描“10mm/10mm/10mm”(即层厚/每螺旋一圈床进距离/重建间隔,Fov300~360mm,标准算法。53例肺内小结节和100例健康体检(包括平扫无阳性发现者)作三维重建(质量透视法-Volume Rendering),取-720HU为重建域下限。结果:阳性者53例中,单个结节47例(左肺21例,右肺26例),结节直径(0.5 cm~3.0cm),比常规扫描更能检出结节边缘凹凸不平及肿瘤供血血管。2个结节2例均为良性(一例手术病理证实为结核,1例抗炎治疗后吸收痊愈)。双肺多发性结节4例(3例为转移瘤,一例为结核)。常规扫描无阳性发现者100例做三维重建,其中92例作健康体检者检出一个结节(0.5cm);8例有癌性病史患者(食道癌6例,肺癌2例),检出两例有结节。结论:胸部螺旋CT三维重建能提高病变检出率及肿块周边的特征改变,从而有助于肺部结节的诊断可靠性,值得临床推广应用。
关键词:
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螺旋断面扫描
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三维重建
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肺部
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结节
Abstract:
Objective : To evaluate the clinical application of three dimension configuration in lung nodus. Material and Methods : Using helical computerized tomography (CT) scan with layer distance/disance between spires/configuration interval as 10mm/10mm/10mm and Fov 300mm-360mm。We made three dimension configuration on 53 cases of lung nodus which were found in routine CT scan and 100 controls in whom no nodus was found in routine CT scan. We defined-720 HU as lower limit of configuration (volume rendering) and compared the result with routing CT scan. Results : Among 53 positive cases, single nodus was found in 47 cases, with 21 in left lung and 26 in right lung. The diameter ranged from 0.5cm to 3.0cm. Rugged edge and vascular figure were clearer in helical than in routine scan. Double noduses were found in 2 cases and all proved to be benign later, with one as tuberculosis and the other as nonspecific infection. Multiple noduses of both lungs were found in 4, with 3 as carcinomatous metastasis and 1 as tuberculosis. Among 100 controls in whom no nodus was found in routine CT scan, a nodus (0.5cm) was found in 92 cases to have health examination and 2 was found in 8 cases with cancer (6 with esophagus cancer and 2 with lung cancer). Conclusions : Three dimension configuration of helical CT scan increased the sensitivity and showed clearer nodular edge feature. It contributes to reliable diagnosis of lung nodus and might be recommendable to clinical application.
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