Application Value Analysis Of Muiti-slice Spiral Computed Tomography (MSCT) Perfusion Imaging Techniques In The Solitary Pulmonary Nodules Differential Diagnosis

Objective: explore the value of SPN in differential diagnosis of benign andmalignant lung clinical, by using multi-slice spiral CT perfusion imaging (SPN) onthe differential diagnosis of solitary pulmonary nodules.Methods：48cases of successful reperfusion were the object of study, those were from66patients who were selected Randomly in our hospital from2012October to2014October treated with solitary pulmonary nodules. using the GE64layer CT scannerperforming CT perfusion scan on48patients, the patiants were dividedinto malignant group, benign group, and inflammatory group according to clinicaldiagnosis.30cases were in malignant group that the main symptoms wereadenocarcinoma, squamous cell carcinoma, metastatic carcinoma or smallcell carcinoma),10cases were in benign group with tuberculoma, pulmonarycyst, bronchogenic cyst or fibrous induration;8patients werein inflammatory Group having the main symptom of lung abscess or organizingpneumonia). by assessing in patients with BF, BV, MTT, PS, TDC and the characteristicparameter, the differential diagnosis was completed.Results： the66selected patients with solitary pulmonary nodule were allconfiermed by pathology, including10cases of benign SPN,30cases of SPN,8cases ofinflammatory SPN;.the BV, MTT, PS values of inflammatory nodules weresignificantly lower than those of malignant nodules (P <0.05), but there was no obviousdifference (BF value P>0.05); the BF, BV, MTT, PS values of benign nodules werelower than those of inflammatory nodules and malignant nodules (P <0.05).Benignpulmonary nodules are thin-walled circular enhancement or enhancement withoutcharacteristics; the degree of enhanced inflammatory pulmonary nodules usuallyappears diversified characteristics such as: uneven enhancement, homogeneousenhancement,orperipheral enhancement; malignant lung nodules aremainly homogeneous enhanced, but if there was necrosis in or around the nodules,it could appear the uneven enhancement. If the BV value is set more than or equalto4m1/100g as threshold of malignant node,the results will be like these:diagnosissensitivity of94.8%, specificity of82.1%, the rate of misdiagnosis was17.9%misseddiagnosis rate was5.1%,the positive predictive value of91.2%and negativepredictive value of91%. enhancement value and carterial enhancementvalue ratio (S/A) of Benign nodular were significantly lower than thatof malignant nodules and inflammatory nodules.. but benign and malignant nodules hasobvious difference in the degree of enhancement, howere there was no significantdifference between benign nodules and inflammatory nodules. enhancement value andarteryre inforcement value ratio (S/A)of Inflammatory nodules were lower than those ofmalignant nodules, and there was no significant difference (P>0.05).6cases of thebenign group showed typeⅢ (3cases of tuberculoma,2cases of fibrous scleroma and1case of induration lung cyst), accounting for about60%of the total number of thisgroup,;4cases of bronchogenic cysts appeared in type II of time density curve, accountingfor about40%of the group;6cases of the inflammatory group performance typeII curve, accounting for75%of the group, the TDC curve of other2cases isnot typical;23cases of malignant group showed curveI, accounting for about76.67%of the total;4cases showed curveⅡ, and the other3cases were without typical curve.Conclusion：the long-term clinical trials confirm that imaging technology of64slicespiral CT perfusion can provide morphology information of solitary pulmonary nodules,observe hemodynamics oh pulmonary nodules and provides the important basis forthe clinical identification of benign and malignant solitary pulmonary nodules. Of course,it can provide important help for clinicians discovering early nodules and diagnosingmalignant nodules,so early treatment of solitary pulmonary nodules can be conducive torealization and improve the patient’s survival rate and the prognosis.