量化分析血管集束征对肺孤立结节的鉴别诊断价值  

Value of Quantitative Analysis on Vascular Convergence in Differential Diagnosis of Solitary Pulmonary Nodules

作　　者：陶鑫[1] 叶兆祥[2] 赵志梅[3] 赵润[1] 顾金法 

机构地区：[1]上海市江湾医院放射科,上海200434 [2]天津肿瘤医院放射科,天津300060 [3]延边大学医学院附属医院放射科,吉林延吉133000

出　　处：《现代诊断与治疗》2007年第1期12-15,共4页Modern Diagnosis and Treatment

摘　　要：目的利用高分辨率CT(HRCT)分析肺结节样病灶影像学特征的基础上,运用Logistic回归分析综合评价并量化分析血管集束征对肺结节的鉴别诊断意义。方法收集经手术病理证实的149例肺结节,其中良、恶性分别为46和103例,所有病例均于术前行常规胸部CT平扫和病灶HRCT扫描。先对病灶常见的征象做单因素分析后,筛选出能对结果产生影响的8个自变量进一步做Logistic回归分析,观察其与良、恶性病变的相关性,并计算OR值,为鉴别诊断提供量化依据。结果103例恶性结节中59例可见血管集束征,综合分析显示血管集束征与恶性病变相关,其OR值为0.576,其倾向于恶性病变的可能性是倾向于良性的1.74倍。结论在HRCT扫描的基础上,Logistic回归分析能够通过对肺结节血管集束征的综合分析,为鉴别诊断提供量化依据。Objective To evaluate the significance of quantitative analysis on vascular convergence by logistic regression in the differential diagnosis of solitary pulmonary nodules, basing on the analysis of its iconographic features by using high-resolution CT（HRCT）. Method A total of 149 cases of solitary pulmonary nodules confirmed by operations were collected,including 46 benign nodules and 103 malignant nodules. HRCT scanning was performed after common CT scanning in all patients. After single factor analysis on focal common signs was performed,8 independent variables which might influence the results were selected to make the logistic regression. Their relationship with benign and malignant nodules was observed, and OR values were calculated in order to provide a quantitative foundation for its differential diagnosis. Results Vascular convergence were observed in 59 cases among 103 cases of malignant nodules. Comprehensive analysis showed that vascular convergence was related to the malignance, and OR value was 0.576. The probability of vascular convergence inclining to the malignance was 1.74 times as much as that to benign lesions. Conclusions By comprehensive analysis on vascular convergence in solitary pulmonary nodules, the logistic regression based on HRCT could provide a quantitative foundation for its distinguishing diagnosis.

关 键 词：硬币病变/肺 体层摄影术/X线计算机 诊断/鉴别 

分 类 号：R563.9[医药卫生—呼吸系统] R814.61[医药卫生—内科学]