肺内孤立结节的高分辨CT征象诊断价值  

Diagnostic value of sign of solitary pulmonary nodule in highresolution CT

作　　者：李辉[1] 姜春霞[2] 宁培刚[3] 阚晓静[3] 陈翠云[3] 武明辉[3] 冯敢生[1] 

机构地区：[1]武汉协和医院放射科,武汉430000 [2]郑州大学学报编辑部,郑州450001 [3]河南省人民医院放射科,郑州450003

出　　处：《郑州大学学报（医学版）》2014年第6期872-875,共4页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:探讨肺内孤立结节(SPN)高分辨CT征象对于良恶性的鉴别诊断价值。方法:回顾性分析经病理学确诊的129例SPN(恶性结节88例,良性结节41例)的高分辨CT征象,对不同征象在良恶性SPN中的发生率进行比较,评价不同指标的诊断敏感度、特异度及准确率。结果:恶性SPN的CT征象中前3位依次为毛刺征、分叶征和血管集束征,均高于在良性SPN中的发生率(χ2=26.590、33.661和5.125,P均<0.05)。当选择毛刺征、分叶征和血管集束征3种征象中的任意3个联合进行良恶性鉴别诊断时,毛刺征和分叶征联合指标的鉴别诊断敏感度、特异度和准确率分别为1.00、0.76和0.92,均高于单一CT征象鉴别诊断效能,3种征象联合鉴别诊断的敏感度未变,而特异度、准确率均下降。结论:高分辨CT能够清晰显示SPN的形态特征,毛刺征联合分叶征能够提高对SPN良恶性鉴别诊断的敏感度、特异度和准确率。Aim：To discuss high-resolution CT features of solitary pulmonary nodule （ SPN） in the differential diagno-sis of benign and malignant SPN .Methods：High-resolution CT features of 129 cases of pathologically confirmed SPN （ 88 cases of malignant SPN and 41 cases of benign SPN ） were retrospectively analyzed .Frequencies of different signs in benign and malignant SPN were compared .Results：The most frequent four CT signs of malignant SPN were spicule sign , lobula-tion, and vascular convergence , which were higher than their frequencies in benign SPN （χ2 =26.590,33.661,5.125,P〈0.05）.When combining any two of spicule sign , lobulation, and vascular convergence as indicator to diagnose benign and malignant SPN , the diagnostic sensitivity , specificity , and accuracy of spicule sign plus lobulation as a combined indicator were 1.00, 0.76, and 0.92, respectively, which were higher than those of single CT sign .Combining all these three signs for diagnosis didn′t affect sensitivity , but showed decreased specificity and accuracy .Conclusion： High-resolution CT could clearly show morphological characteristics of SPN .Combined use of spicule sign and lobulation could increase sensi-tivity, specificity, and accuracy of the differential diagnosis between benign and malignant SPN .

关 键 词：CT肺 结节 诊断 

分 类 号：R734.2[医药卫生—肿瘤]