MSCT扫描重建技术在肺局限性磨砂玻璃样病变定性诊断的价值  被引量:1

The value of MSCT scan reconstruction technique in qualitative diagnosis of pulmonary focal ground-glass opacity

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作  者:袁焕初[1] 郑晓林[1] 邹玉坚[1] 王刚[1] 谢锐文[2] YUAN Huanchu;ZHENG Xiaolin;ZOU Yujian;WANG Gang;XIE Ruiwen(Department of Radiology,Dongguan People's Hospital, Dongguan 523059,China;Thoracic Surgery,Dongguan People's Hospital,Dongguan 523059,China)

机构地区:[1]广东省东莞市人民医院放射科,广东东莞523059 [2]广东省东莞市人民医院胸外科,广东东莞523059

出  处:《中国医药科学》2017年第15期122-125,185,共5页China Medicine And Pharmacy

基  金:广东省东莞市科技计划医疗卫生类科研一般项目(20131051010121)

摘  要:目的研究256层CT扫描后,重建技术对肺内局限性磨砂玻璃样病变的诊断价值。方法选择行256层CT检查所检出的最大直径≤3.0cm的f GGO患者57例,用多方位高分辨率重建的方法观察病变内支气管的改变,将f GGO内支气管改变分为2型:Ⅰ型:支气管在病灶中截断、变尖消失;Ⅱ型:支气管在病变中走行、扭曲、粗细不均,或走行正常。分别用轴位、多方位(包括横断位、多平面重建等)观察57例患者的支气管的改变。再测量病灶三维比例,并观察病灶周围是否存在血管集束征、胸膜凹陷征,其在肺癌和非肿瘤性病变之间差异是否具有统计学意义。结果横断位完整显示病变内支气管异常11个,其中支气管截断、消失(I型)5个,支气管穿行其中(Ⅱ型)6个。多方位显示病变内支气管异常及走行正常57个,其中支气管截断、消失16个,支气管穿行其中41个。两种显示方法的比较,差异有统计学意义(χ2=14.04,P<0.01)。以CT上Ⅰ型支气管表现定为诊断肺癌的依据,结果为恶性16个,与病理和随访结果对照,CT诊断为恶性结果中,正确16个,诊断正确率100%(16/16),但未检出者26例,假阴性率高。以Ⅰ型、Ⅱ型支气管表现定为诊断肺癌的依据,结果为恶性57个,与病理和随访结果对照,诊断为恶性结果中,正确42个,错误15个。诊断恶性病变正确率73.7%(42/57),但敏感性、特异性较低。肺癌组、非肿瘤性病变组的三维比率分别为(1.20±0.18),(1.59±0.21),差异有统计学意义(P<0.01)。肺癌组、非肿瘤性病变组的胸膜凹陷征,血管集束征比率有统计学意义(P<0.05)。结论采用多方位重建方法,有利于显示f GGO内支气管的改变,观察是否有血管集束征、胸膜凹陷征;准确测量其三维比例,有助于判断f GGO的性质。Objective To evaluate the diagnostic value of MSCT scan technique in localized localized frosted glasslesions(fGGO)of the lung.Methods57cases of fGGO patients with maximum diameter less than3.0cm for256layer CTexamination were selected.The changes of bronchi in the lesions were observed by high resolution and multi directionalreconstruction.The bronchial changes in fGGO was divided into2types:type I:bronchial cut off in the lesion and taperingout,typeⅡ:bronchial in the lesion,moving,twisting,uneven,or normal.The axial and multi direction(including transverse andmultiplanar reconstruction)were used to observe the bronchial changes of57cases.Then,the three-dimensional ratio of thelesions was statistically different between lung cancer and non neoplastic lesions(P<0.05).And the presence of vascularbundle sign and pleural adhesion sign around the lesion was observed.Results The transverse position showed11abnormalbronchial abnormalities,of which5were bronchial transection and disappearance(I type),and6of them were bronchialpassage(typeⅡ).There were57bronchial abnormalities and41normal movements,among them,16were bronchial cutand disappeared,and the other was through bronchus.Theχ2value of two display methods were14.04,P<0.01,there wasstatistically significant difference.The CT type for the diagnosis of lung cancer bronchial performance basis,results werethe16malignant,and the control results of pathology and follow-up,CT for the diagnosis of malignant results,right for16cases,the correct diagnosis rate of100%(16/16),but26cases were not detected,the false negative rate was high.With typeI and typeⅡbronchial manifestations as the basis for the diagnosis of lung cancer,the results were57malignant.Compared with the pathological and follow-up results,the diagnosis was malignant,and the result was42correct and15wrong.Lung cancergroup and non dimensional ratio of tumor lesions group were(1.20±0.18),(1.59±0.21),(P<0.01),the difference was statisticallysignificant(P<0.05).MSCT findings of pleural indentation and vasc

关 键 词:CT重建技术 肺局限性磨玻璃密度结节 支气管 三维比例 体层摄影术 X线计算机 

分 类 号:R816.41[医药卫生—放射医学]

 

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