数字断层融合摄影在肺转移结节诊断和随访中的价值  

Value of Chest Digital Tomosynthesis in the Diagnosis and Follow-up of Pulmonary Metastasis Nodules

作　　者：赵张平[1] 朱文玲[1] 陈世沛[1] 滕红[1] 严天军[1] 李剑波[1] 

机构地区：[1]攀枝花市中心医院医学影像中心,四川攀枝花617067

出　　处：《中国医学影像学杂志》2013年第1期24-26,30,共4页Chinese Journal of Medical Imaging

基　　金：四川省卫生厅科学研究项目(川110640)

摘　　要：目的探讨胸部数字断层融合(DTS)检查对恶性肿瘤肺转移结节的诊断和随访价值。资料与方法对257例恶性肿瘤患者进行胸部DTS检查和数字X线摄影(DR)检查,以多层螺旋CT作为参照,比较DTS和DR对肺转移结节的检出情况,评估DTS对肺转移结节的诊断效能。结果 257例患者中,34例发生肺转移,共确认187个转移结节。DR检出16例共计65个结节,DTS检出31例共计164个结节。DR和DTS对恶性肿瘤肺转移的诊断敏感性、特异性、阳性预测值、阴性预测值分别为47.1%、87.9%、37.2%、91.6%和91.2%、99.6%、96.9%、98.7%。DTS对直径<5mm和5～10mm的肺转移结节的检出率明显高于DR(P<0.01)。结论 DTS较DR对肺转移结节具有更高的敏感性,可用于转移性肺癌的诊断和随访。Purpose To explore the value of chest digital tomosynthesis （DTS） in the diagnosis and follow-up of pulmonary metastasis nodules. Materials and Methods 257 patients with primary malignant tumor were recruited in the study. Chest DTS and digital radiography （DR） were performed in all patients. Multidetector CT was served as golden standard. Detection rate of chest DTS and DR was compared, and the diagnostic efficiency of DTS for pulmonary metastasis nodules was evaluated. Results Among the 257 patients, 187 metastasis nodules were found in 34 patients. 16 patients with 65 nodules were detected on chest DR, and 31 patients with 164 nodules were detected on chest DTS. The sensitivity, specificity, positive and negative predictive values of chest DR were 47. 1%, 87.9%, 37.2% and 91.6%, respectively, and those of DTS were 91.2%, 99.6%, 96.9% and 98.7%, respectively. The detection rates of DTS in detecting pulmonary metastasis nodules with diaineter less than 5 mm and 5-10 mm were statistically higher than those of DR （P〈0.01）. Conclusion Chest DTS is better than chest DR in detecting puhnonary metastasis nodules, it can be a practicable conventional technique for detection and follow- up of pulmonary cancer.

关 键 词：肺肿瘤 肿瘤复发 数字断层融合 放射摄影术 胸部 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]