64排螺旋CT肺部后处理重建技术在非肺癌性结节诊断中的应用研究  

Application of 64-slice spiral CT pulmonary post-processing reconstruction technique in the diagnosis of non-lung cancer nodules

作　　者：刘加良 陈文宇 吕晓东 方志仙 孙延豹 杨芝萍 刘倬达 LIU Jialiang;CHEN Wenyu;LV Xiaodong;FANG Zhixian;SUN Yanbao;YANG Zhiping;LIU Zhuoda(Department of Respiratory Medicine,Jiaxing First Hospital in Zhejiang Province,Jiaxing 314000,China;Department of Radiology,Jiaxing First Hospital in Zhejiang Province,Jiaxing 314000,China;Department of Oncology,Jiaxing First Hospital in Zhejiang Province,Jiaxing 314000,China;Quality Control Department,Jiaxing First Hospital in Zhejiang Province,Jiaxing 314000,China)

机构地区：[1]浙江省嘉兴市第一医院呼吸科,浙江嘉兴314000 [2]浙江省嘉兴市第一医院放射科,浙江嘉兴314000 [3]浙江省嘉兴市第一医院肿瘤科,浙江嘉兴314000 [4]浙江省嘉兴市第一医院质管科,浙江嘉兴314000

出　　处：《中国现代医生》2018年第33期10-13,18,169,共6页China Modern Doctor

基　　金：国家自然科学基金(81650012);浙江省嘉兴市科技局计划项目(2015AY23016);浙江省嘉兴市医学重点学科呼吸科(04-Z-11);浙江省嘉兴市肺癌早期诊断和综合治疗创新团队

摘　　要：目的探讨64排胸部螺旋CT后处理重建技术在非肺癌性肺结节中诊断的作用。方法回顾性分析我院2016年1～12月期间经手术病理确诊的78例肺原位腺癌患者和45例非肺癌患者的64排螺旋CT肺部后处理重建影像资料,比较和总结两者的影像学特征。结果 (1)非肺癌患者肺部CT后处理重建影像以实性结节多见,周围不规则、边缘毛刺征、血管丛集征和空泡征等少见,纵隔窗显示、病灶钙化和病灶强化等多见。肺原位腺癌患者则以磨玻璃结节多见,周围不规则、边缘毛刺征、血管丛集征和空泡征等多见,未见纵隔窗显示、病灶钙化和病灶强化等,两者在上述影像学特征方面存在显著性差异(P<0.01)。(2)两组在周围花瓣征和胸膜凹陷征等影像学表现方面无显著性差异(P>0.05)。结论 64排螺旋肺部CT后处理重建技术能更清晰地了解肺小结节的细微影像改变,对判断小结节性质提供了更多的影像学依据,如能进一步与临床资料结合分析,则能有效提高肺结节诊治的临床决策水平。Objective To investigate the role of64-slice chest spiral CT post-processing reconstruction technique in the diagnosis of non-lung cancer pulmonary nodules.Methods The image data of78cases of pulmonary in situ adenocarcinoma patients45cases of non-lung cancer patients diagnosed by surgery and pathology and with64-slice spiral CT lung reprocessing after reconstruction from January2016to December2016were retrospectively analyzed.The imaging features of both were compared and summarized.Results①Non-lung cancer patients with post-CT reconstruction of the lungs were more common with solid nodules.Irregularities around the periphery,marginal burrs,vascular clusters and vacuoles were rare.Mediastinal window display,lesion calcification and lesions strengthening were common.Pulmonary in situ adenocarcinoma patients were more common in ground glass nodules,irregular surrounding,marginal burr signs,vascular cluster signs and vacuoles signs,without mediastinal window display,lesion calcification and lesion enhancement.There was a significant difference in the above imaging features(P<0.01).②There was no significant difference between the two groups in imaging performance including the surrounding petal sign and pleural recession(P>0.05).Conclusion64-slice spiral lung CT post-processing reconstruction technique can more clearly understand the subtle image changes of small pulmonary nodules,and provide more imaging evidence for judging the nature of small nodules.If it can be further combined with clinical data,it can effectively improve the clinical decision-making level of diagnosis and treatment of pulmonary nodules.

关 键 词：64排螺旋CT 后处理重建技术 肺结节 非肺癌 影像学特征 

分 类 号：R734.2[医药卫生—肿瘤]