最大似然法在孤立性肺结节鉴别诊断中的应用价值  

The Value of the Maximum Likelihood Method in the Differential Diagnosis of the Solitary Pulmonary Nodules

作　　者：张庆华[1] 夏国兵[2] 胡春洪[2] 杨忠保[1] 侯安海[1] 何世明[1] 

机构地区：[1]江苏省溧水县人民医院放射科,江苏溧水211200 [2]苏州大学附属第一医院放射科,江苏苏州215006

出　　处：《中国血液流变学杂志》2012年第4期713-717,共5页Chinese Journal of Hemorheology

摘　　要：目的探讨应用最大似然法对周围型肺癌、良性肿瘤、结核球及炎性结节4种孤立性肺结节的诊断价值。方法选择60例孤立性肺结节做为研究对象，所有病例均经手术或穿刺活检病理证实，其中周围型肺癌36例、良性肿瘤6例、结核球8例、炎性结节10例。所有病例分别采用最大似然法和常规阅片法进行分析判别。以病理及临床诊断为对照标准，将上述两种方法的诊断结果行统计学比较。结果最大似然法诊断正确率分别为周围型肺癌80．6％（29／36）、良性肿瘤83．3％（5／6）、结核球75．0％（6／8）及炎性结节80．0％（8／10），总平均诊断正确率为80．0％（48／60）；常规阅片法诊断正确率分别为周围型肺癌69．4％（25／36）、良性肿瘤66．7％（4／6）、结核球62．5％（5／8）及炎性结节70．0％（7／10），总平均诊断正确率为68．3％（41／60）；最大似然法总平均诊断正确率较常规阅片法高，但差异无统计学意义（x2=1．89，P=0．167〉0．05）。结论与常规阅片法相比，最大似然法对4类SPN的诊断正确率均有所提高，虽然统计学无显著差异，但仍可用于指导日常阅片工作，特别是对于年轻医师或基层医院医师，可以弥补其经验不足。Objective To evaluate the value of the maximum likelihood method in differentiating the 4 kinds of SPN among peripheral lung carcinoma,benign tumors,tuberculomas,inflammatory nodules.Methods 60 cases of pathologically proved SPN were selected for studying objects,including 36 cases of peripheral carcinomas,6 benign tttmors,8 tuberculomas, 10 inflammatory nodules.All cases were analyzed with the maximum likelihood method and the traditional method,respectively.Comparison was made on diagnostic results from the use of traditional method and the maximum likelihood method.Results The diagnostic accuracy with the maximum likelihood method of peripheral lung carcinoma,benign tumor, tuberculoma,inflammatory nodule were 80.6%（29/36）,83.3%（5/6）,75.0%（6/8）,80.0%（8/lO）,respectively.The mean accuracy was 80.0%（48/60）. The diagnostic accuracy with the traditional diagnostic method of peripheral lung carcinoma,benign tumor, tuberculoma,inflammatory nodule were 69.4%（25/36）,66.7%（4/6）,62.5%（5/8）,70.0%（7/10）,respective- ly.The mean accuracy was 68.3%（41/60）.Although the mean accuracy of former method was higher than the latter, there was no statistical difference0f2 = 1.89,P=-0.167 〉 0.05）.Conclusion The maximum likelihood method is a useful instrument for the statistical diagnosis of SPN,compared with the traditional method.Without statistically significance,it still can be applied to the daily routine study.

关 键 词：孤立性肺结节 最大似然法 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学]