螺旋CT三维重建对肺占位性病变的诊断及与病理相关性  

Three-dimensional reconstruction of spiral CT in the diagnosis of lung occupying lesions and its correlation with pathology

作　　者：朱志梅[1] 彭康明[1] 周江云[1] 马珺[2] 鲍健[3] ZHU Zhimei;PENG Kangming;ZHOU Jiangyun;MA Jun;BAO Jian(Department of Radiology,Rugao people's Hospital,Rugao 226500,P.R.China;Nanjing Traditional Chinese Medicine University,Nanjing 210029,P.R.China;Department of Medical Imaging,Wuxi people's Hospital Affiliated to Nanjing Medical University,Wuxi 214023,P.R.China)

机构地区：[1]江苏省如皋市人民医院放射科,江苏如皋226500 [2]南京中医药大学,江苏南京210029 [3]南京医科大学附属无锡市人民医院医学影像科,江苏无锡214023

出　　处：《医学影像学杂志》2020年第2期200-203,共4页Journal of Medical Imaging

基　　金：国家自然科学基金委员会资助(青年科学基金项目)(编号:81703758);南京医科大学附属无锡市人民医院科研项目(编号:RYC201801)。

摘　　要：目的探讨肺占位性病变64排螺旋CT三维重建特点及与其病理类型、良恶性肿瘤的关系。方法回顾性分析2016年3月~2018年3月在本院就诊的肺占位性病变患者103例。均进行常规64排螺旋CT检查,并进行三维重建后处理技术,以病理结果为金标准,分析64排螺旋CT三维重建的临床应用价值。结果64排螺旋CT三维重建对肺占位性病变结节检出率显著高于常规CT(P<0.05)。恶性肿瘤分叶征,小气道改变,胸膜凹陷征,毛刺征,血管纠集征出现比例显著高于非肿瘤患者(P<0.05)。64排螺旋CT三维重建对肺癌诊断的灵敏度,准确度和特异度均显著高于常规CT(P<0.05)。且64排螺旋CT三维重建对肺癌的诊断结果与病理诊断结果具有极好的一致性(Kappa=0.858)。结论肺占位性病变64排螺旋CT三维重建特点与其病理类型、良恶性肿瘤具有一定的相关性,可用于临床诊断肺癌,具有较高的临床价值。Objective To investigate the characteristics of 64-slice CT 3D reconstruction in pulmonary space occupying lesions and its relationship with pathological types,benign and malignant tumors.Methods 103 patients with pulmonary space occupying lesions from March 2016 to March 2018 were retrospectively analyzed.64-slice CT,643D reconstruction was analyzed by using the pathological results as the gold standard,and the clinical value of the three-dimensional reconstruction of 64-slice CT was analyzed.Results The detection rate of pulmonary lesion nodules by 64-slice CT 3D reconstruction was significantly higher than that of conventional CT(P<0.05).The internal structure(mixed density nodule),lobulation sign,small airway change,pleural indentation sign,burr sign and vascular entanglement sign in malignant tumors were significantly higher than those in non-tumor patients(P<0.05).The sensitivity,accuracy and specificity of 64-slice CT three-dimensional reconstruction were significantly higher than those of conventional CT(P<0.05).The results of 64-slice CT 3D reconstruction were in good agreement with pathological results(Kappa=0.858).Conclusion The characteristics of 64-slice CT 3D reconstruction of pulmonary space occupying lesions are correlated with their pathological types,benign and malignant tumors,and can be used in the clinical diagnosis of lung cancer,which is of high clinical value.

关 键 词：肺占位性病变 病理类型 肿瘤 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]