增强CT扫描和^(99m)Tc-MIBI-SPECT/CT同机融合显像鉴别孤立性肺结节的临床研究  

The Diagnosis Value on Solitary Pulmonary Nodule between Enhanced MSCT Scan and ^(99m)Tc-MIBI-SPECT/CT Fusion Imaging

作　　者：周淼 马学进 江林 徐仕前 柏拉拉 靖功伟 李仕广 ZHOU Miao;MA Xuejin;JIANG Lin(The Third Affiliated Hospital of Zunyi Medical University(The First People’s Hospital of Zunyi),Zunyi,Guizhou 563000,P.R.China)

机构地区：[1]遵义医科大学第三附属医院(遵义市第一人民医院),563000

出　　处：《临床放射学杂志》2021年第7期1303-1307,共5页Journal of Clinical Radiology

基　　金：遵义市科技局资助项目[遵市科合HZ字(2019)179号]。

摘　　要：目的比较增强CT扫描和^(99m)Tc-MIBI-SPECT/CT同机融合显像在孤立性肺结节(SPN)良、恶性鉴别诊断中的价值,探究该病的最佳检查方式。方法搜集本院77例经常规平扫CT检查发现肺部结节并在1周内行增强CT扫描和^(99m)Tc-MIBI-SPECT/CT同机融合显像的患者,分析两种影像技术对SPN良、恶性的鉴别诊断效能。结果增强CT扫描检查发现SPN中恶性57例,良性20例;^(99m)Tc-MIBI-SPECT/CT同机融合显像发现SPN中恶性51例,良性26例。增强CT扫描的曲线下面积为0.765,灵敏度为95.5%,特异度为42.4%;^(99m)Tc-MIBI-SPECT/CT同机融合显像的曲线下面积为0.67,灵敏度为79.5%,特异度为45.5%。两种影像技术检查结果的Kappa一致性检验K值为0.446。增强CT扫描中毛刺征、胸膜凹陷征、微血管征或血管集束征和结节直径在良、恶性SPN中的差异有统计学意义(P<0.05)。结论增强CT扫描较^(99m)Tc-MIBI-SPECT/CT同机融合显像具有较高的诊断效能,其诊断良恶性SPN的主要依据为毛刺征、胸膜凹陷征、微血管征或血管集束征和结节直径。Objective To compare the diagnostic value of solitary pulmonary nodule(SPN)between enhanced MSCT scans and ^(99m)Tc-MIBI-SPECT/CT fusion imaging so as to explore the best imaging method for SPN.Methods Our study included 77 patients with SPN,who were examined with an ordinary CT scan,and further examined with enhanced CT scans and ^(99m)Tc-MIBI-SPECT/CT fusion imaging.Then the ROC curve,cut-off value,and Kappa consistency of two imaging methods were analyzed.Results 57 SPN cases were diagnosed as malignant and 20 SPN cases were diagnosed as benign,respectively,by the enhanced MSCT scan.51 SPN cases were diagnosed as malignant and 26 SPN cases were diagnosed as benign,respectively,by the ^(99m)Tc-MIBI-SPECT/CT fusion imaging.The AUC of the enhanced MSCT scan was 76.5%with a sensitivity and specificity rate of 0.955 and 0.424,respectively.In comparison,the AUC of ^(99m)Tc-MIBI-SPECT/CT fusion imaging was 67%with a sensitivity and specificity rate of 0.795 and 0.455,respectively.The Kappa consistency rate of these two examine methods is 0.446.Burr,pleural depression,microvascular sign or vascular cluster sign,and SPN diameter are the influencing factors for the enhanced MSCT scan(P<0.05).Conclusion Enhanced MSCT scan has higher diagnostic value in comparison to ^(99m)Tc-MIBI-SPECT/CT fusion imaging,which bases on burr,pleural depression,microvascular sign or vascular cluster sign,as well as SPN diameter.

关 键 词：孤立性肺结节 增强CT ^(99m)Tc-MIBI-SPECT/CT同机融合 毛刺征 

分 类 号：R730.44[医药卫生—肿瘤] R734.2[医药卫生—临床医学]