多层螺旋CT多种重建后处理技术对肺内磨玻璃结节的早期定性诊断研究  

Research of Early diagnosis of multiple reconstruction processing of multislice spiral CT technology in ground-glass lung nodules

作　　者：吕英刚[1] 暴军辉[2] 刘贵廷[1] 徐殿国[1] 石俊岭[1] 王保刚 闫巧焕[1] 

机构地区：[1]河北工程大学附属医院影像二科,056002 [2]邯郸市第一医院老年一科 [3]邯郸市第六医院影像科

出　　处：《心肺血管病杂志》2015年第11期853-857,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：河北省科技支撑项目(编号12276104D-19);邯郸市科学技术研究与发展项目(0923108054-5);河北省医学科学研究重点课题计划项目(20090188)

摘　　要：目的:探讨多层螺旋CT多种重建后处理技术对肺内磨玻璃病变的早期定性诊断的价值。方法:选取2011年3月至2015年1月,在我院经过手术或者穿刺活检证实的肺内磨玻璃结节患者132例,经多层螺旋CT扫描后采用多平面重建技术(multiplane reconstruction MPR)、最大密度投影法(Maximum intensity projection,MIP)以及容积成像法(volume rendering,VR)进行图像后处理,分析不同后处理技术的征象。结果:MPR、MIP及VR以及联合重建处理后,良性病变与恶性病变在病灶平均大小方面差异无统计学意义(P>0.05);三者联合处理技术在结节边缘形态(光滑)及邻近结构改变(胸膜凹陷征、血管集束征)与单一后处理技术相比,差异具有统计学意义(P<0.05);三者联合处理技术在结节边缘形态(不规则毛刺、棘状突起)、病灶形态(圆形/椭圆)、瘤肺界面(清楚、模糊)及邻近结构改变(血管集束征)与单一后处理技术相比,差异具有统计学意义(P<0.05);ROC曲线分析显示,多层螺旋CT后处理技术对GGN的诊断准确性以及曲线下面积(AUC)依次为:三者联合>MPR>MIP>VR。结论:多层螺旋CT扫描后结合MPR、MIP以及VR等重建后处理技术对早期GGN的定性诊断效果明显,值得推广。Objective： To investigate the value of the reconstruction process of multislice spiral CT technology for the early diagnosis of ground-glass pulmonary lesions. Methods： 132 cases of ground-glass nodules were selected in our hospital in March 2011 to January 2015 after surgery or biopsy confirmed,after using MPR,MIP and VR of the multi-slice spiral CT scan and conducted the image processing,then analysis the difference of the signs of post-processing techniques. Results： MPR,MIP and VR and the combined post-processing reconstruction,the terms of the average size in benign and malignant lesions was not statistically significant（ P 0. 05）,the combined processing in the form of nodules edge（ smooth） and adjacent structure changes（ pleural indentation,vascular convergence sign） compared to a single post-processing technologies,had a significant difference（ P 0. 05）. The combined processing technology with the edge in nodular form（ irregular burr,spinous process）,lesion morphology（ round / oval）,lung tumor interface（ clear,blur） and adjacent structural changes（ vascular convergence sign） y,compared witha single post-processing technolog had a significant difference（ P 0. 05）. ROC curve analysis,the area under the curve as well as accuracy after the diagnostic by multi-slice spiral CT processing technique on GGN＇s（ AUC） as follows： the combined techniques MPR MIP VR. Conclusion： Spiral CT scanning and multi-MPR,MIP and VR reconstruction and other processing techniques for early diagnosis GGN＇s effect was obvious,it was worth promoting.

关 键 词：多层螺旋CT 肺内磨玻璃样结节 多平面重建技术 最大密度投影法 容积成像法 

分 类 号：R54[医药卫生—心血管疾病]