肺部孤立结节钙化征象的HRCT评价

目的：本文旨在评价良恶性孤立结节（ＳＰＮＳ）的钙化征象在高分辨率ＣＴ（ＨＲＣＴ）上的差异。材料和方法：分析一组连续的资料，共５９例，其中４３例经病理学证实，１６例经临床诊断和随访明确。结果：３０例良性中的１２例（４０％），２９例恶性中的４例（１３石的）可见钙化征象（Ｐ＜０．０５）。钙化的形态有三种，１）结节状或斑炔状，２）点状，３）沙粒状。结节状或斑块状钙化是良性的特征。良恶性钙化分布不同，良性多位于中央，恶性则为偏心性的。ＨＲＣＴ所显示的１６例钙化中普通ＣＴ扫描仅显示３例。结论：ＨＲＣＴ上钙化征象多见于良性ＳＰＮＳ．但并非良性病变所特有，钙化对良恶性结节的鉴别有一定的参考价值。在钙化的显示上，ＨＲＣＴ明显优于普通Ｘ线及常规ＣＴ扫描。

Calcification in SPNs:Assessment with HRCT

The study was to evaluate the difference of calcifications between the benign and malignant solitary pulmonary nodules (SPNs) by high-resolution CT (HRCT). Materials and Methods: Fifty-nine consecutive cases of SPNs, in which 43 cases confirmed by pathology and 16 cases by clinical critera, had been analysed by HRCT and conventional CT (CCT). Results: On HRCT. calcification was demonstrated in 12 of 30 (40%) benignities and in 4 of 29 (13.8%)malignancies. There was significant difference between the two kinds of SPNs (P< 0.05).Three patterns of calcification were shown: 1) nodular or Pathy, 8 in benignancies and 1 in malignancies (P< 0.05),2)mottling, 3 in benignancies and 1 in malignancies (P> 0.05),3)stippling, 1 in benignancies and 2 in malignancies. Nodular and patchy calcifications were usually seen in benignancies. The distribution of calcification in SPNs was also different. Benign calcification were usually located in the center and malignant ones in the periphery. On CCT, only 3 cases of SPN'scalcification could be detected as comparing to 16 cases by HRCT. Conclusion: The study showed that calcifications in SPNs were usually seen in benignancies, but not only the specific sign which is useful differential evaluation. HRCT is superior to chest radiography and conventional CT in detecting calcification within SPNs.