64排螺旋CT鉴别诊断肺孤立小结节结果分析  

Result Analysis of 64-slice Spiral CT in Differential Diagnosis of Solitary Pulmonary Nodule

作　　者：季利涛 JI Litao(The Imaging Department, Xingyang People’s Hospital, Xingyang Henan 450100, China)

机构地区：[1]荥阳市人民医院影像科,河南荥阳450100

出　　处：《河南医学高等专科学校学报》2020年第3期244-247,共4页Journal of Henan Medical College

摘　　要：目的探讨64排螺旋CT鉴别诊断肺孤立小结节的临床价值。方法选取肺孤立小结节患者80例,均行64排螺旋CT诊断,且经手术病理活检确诊,并以病理诊断结果为“金标准”,评估64排螺旋CT诊断肺孤立小结节良恶性的灵敏度、特异度及准确度,并比较分析良恶性结节影像学特征及动态增强CT值。结果经手术病理诊断80例肺孤立小结节中,50例为恶性结节,30例为良性结节;以病理诊断结果为“金标准”,64排螺旋CT诊断肺孤立小结节灵敏度为92.00%(42/50),特异度为90.00%(27/30),准确度为91.25%(73/80);与病理结果具有极好的一致性(Kappa=0.815);恶性结节边缘清晰占比,内部结构钙化占比均低于良性结节,边缘毛刺、分叶或不规则占比,内部结构均匀占比高于良性结节,差异均有统计学意义(P<0.05);恶性结节内部结构卫星灶占比与良性结节比较,差异无统计学意义(P>0.05);恶性结节在不同时间段CT值均高于良性结节,差异有统计学意义(P<0.05)。结论64排螺旋CT在鉴别肺孤立小结节良恶性中具有较高的应用价值,可为临床早期诊治提供重要依据。Objective To investigate the clinical value of 64-slice spiral CT in the differential diagnosis of solitary pulmonary nodule.Methods 80 patients with solitary pulmonary nodule were selected,received 64-slice spiral CT examination and diagnosed by surgical pathological biopsy testing.With the pathological diagnosis results as the gold standard,the sensitivity,specificity and accuracy of 64-slice spiral CT in the diagnosis of the benign and malignant solitary pulmonary nodule were evaluated.The imaging features and dynamic contrast-enhanced CT values of benign and malignant nodules were compared.Results Among 80 patients with solitary pulmonary nodule diagnosed by surgical pathology,there were 50 cases with malignant nodule and 30 cases with benign nodule.With the pathological diagnosis results as the gold standard,the sensitivity,specificity,accuracy of 64-slice spiral CT in the diagnosis of solitary pulmonary nodules were respectively 92.00%(42/50),90.00%(27/30),91.25%(73/80),which were very consistent with the pathological results(Kappa=0.815).The proportions of marginal sharphness and internal structural calcification in the malignant nodules were lower than those in the benign nodules,the proportions of marginal burr,lobulation or irregularity,and the internal structure uniformity in the malignant nodules were higher than those in the benign nodules,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the proportion of the satellite lesions of internal structures between malignant nodules and benign nodules(P>0.05).The CT values of malignant nodules at different time periods were higher than those of benign nodules,with statistically significant differences(P<0.05).Conclusion 64-slice spiral CT is of higher application value in the differential diagnosis of benign or malignant solitary pulmonary nodules,which can provide an important basis for early diagnosis and treatment.

关 键 词：肺孤立小结节 64排螺旋CT 影像学特征 

分 类 号：R563[医药卫生—呼吸系统] R816.41[医药卫生—内科学]