CT 血管征特性在肺部微小结节病变定性及鉴别诊断中的应用效果分析  

The application effect of CT angiography features on qualitative and differential diagnosis of small nodules in the lung lesions

作　　者：李莹 谢继承[2] 周亚敏[3] Li Ying Xie Jicheng Zhou Yamin(Department of Radiology, the First People＇s Hospital of Linhai City, Linhai , Zhejiang 317000, China （ Li Y Department of Radiology, the Affiliated Taizhou Hospital of Wenzhou Medical University, Taizhou, Zhejiang 317000, China （ Xie JC Department of ICU, the Affiliated Taizhou Hospital of Wenzhou Medical University Zhejiang, Taizhou, Zhejiang 317000, China （ Zhou YM)

机构地区：[1]临海市第一人民医院放射科,浙江省临海317000 [2]温州医科大学附属台州医院放射科,浙江省台州317000 [3]温州医科大学附属台州医院ICU,浙江省台州317000

出　　处：《中国基层医药》2016年第21期3201-3205,I0002,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省台州市科技计划项目（14SF03）

摘　　要：目的：研究 CT 血管征特性在肺部微小结节病变定性及鉴别诊断中的应用效果。方法选取2014年9月至2015年10月于呼吸内科住院治疗并行 CT 扫描的肺部微小结节病变患者共120例，依据患者的病理分型将入组患者分为两组，其中恶性病理改变的患者为观察组，共计64例；良性病理改变的患者为对照组，共计56例。行 CT 扫描后比较两组的病变类型、敏感度、血管征类型、CT 强化峰值及强化峰值与主动脉强化值的比值。结果观察组 CT 血管征阳性50例，阴性14例，敏感性78．1％；对照组 CT 血管征阳性16例，阴性40例，敏感性28．6％。两组血管征敏感性差异有统计学意义（χ2＝6．781，P ＝0．012）；两组血管征阳性患者血管征分型情况差异均有统计学意义（χ2＝7．694、6．964、5．993、6．012，均 P ＜0．05）。观察组血管征呈现阳性反应者增强扫描 CT 值为（40．07±3．72）Hu，对照组为（10．54±4．83）Hu，两组差异有统计学意义（t ＝11．783，P ＝0．019）；观察组血管征呈现阳性反应者 CT 强化峰值与主动脉强化值的比值为24．96％，对照组为4．01％，两组差异有统计学意义（χ2＝7．460，P ＝0．012）。结论 CT 血管征特性在肺部微小结节病变的定性及鉴别诊断中起到了十分重要的作用，对临床诊治意义重大，值得进一步推广使用。Objective To investigate the effect of CT angiography on the qualitative and differential diagnosis in small pulmonary nodules.Methods 120 patients with pulmonary small nodular lesions from September 2014 to October 2015 in our hospital were selected,and they were divided into the observation group and control group according to pathological type.the patients with malignant pathology were in the observation group,with totaling 64 cases;the patients with benign pathology were selected as a control group,with a total of 56 cases.Lesion type,sensitivity,vascular sign type,CT enhancement value and the ratio of enhancement value to aorta value in the two groups were compared and analyzed after the CT scan.Results In the observation group,positive CT angiography sign was 50 cases while negative ones was 14 cases,the sensitivity was 78.1%;In the control group,CT angiography sign was positive in 16 cases,negative in 40 cases,with the sensitivity of 28.6%.Comparing of two vascular symptoms sensitive case, there was a significant difference（χ2 =6.781,P =0.012）.Vascular symptoms genotyping were compared in vascular symptoms positive patients,the results showed significant differences（χ2 =7.694,6.964,5.993,6.012,all P 〈0.05）.Enhanced CT scan value of patients showed positive signs in the observation group was （40.07 ±3.72）Hu, with the control group of （10.54 ±4.83）Hu,the difference was statistically significant（t =11.783,P =0.019）.The ratio of enhancement CT value to aorta value in patients with positive reaction showed 24.96% in the observation group,and 4.01% in the control group,the difference was statistically significant（χ2 =7.460,P =0.012）.Conclusion 〈br〉 CT angiography features has played a very important role in qualitative and differential diagnosis of small nodular lesions in the lungs.It is of great significance in the clinical diagnosis and treatment,and is worth further promotion.

关 键 词：体层摄影术 X 线计算机 血管征 肺部微小结节病变 诊断 鉴别 

分 类 号：R563[医药卫生—呼吸系统] R816.4[医药卫生—内科学]