多层CT在囊腔型肺癌及空洞型肺结核诊断中的价值  

Value of multidetector CT in diagnosis of cystic lung cancer and cavitary pulmonary tuberculosis

作　　者：周强 周维彬[1] 钟凯[1] 罗林[1] ZHOU QIANG;ZHOU Wei-bin;ZHONG Kai;LUO Lin(Department of Radiology,Jianyang People's Hospital,Jianyang 641400,Sichuan,China)

机构地区：[1]简阳市人民医院放射科,四川简阳641400

出　　处：《生物医学工程与临床》2021年第5期580-585,共6页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨多层CT(MDCT)在囊腔型肺癌及空洞型肺结核患者鉴别诊断中的应用价值。方法选择肺部病变患者164例,其中男性92例,女性72例;年龄45~79岁,平均年龄62.8岁。对患者的CT影像学资料进行分析,记录病灶最大直径、囊壁最大厚度,并观察腔壁是否均匀、腔内壁规整度、腔内是否分隔、腔内是否有血管形成、病灶是否出现分叶、毛刺征、患者是否伴有胸膜凹陷等影像学特征,并以病理诊断结果作为金标准,计算MDCT诊断灵敏度、特异度、漏诊率和误诊率等相关诊断学指标。结果根据病灶性质不同,分为恶性组(伴有薄壁囊腔型肺癌)84例和良性组(空洞型肺结核)80例。恶性组患者的病灶最大直径、囊壁最大厚度测定值均低于良性组患者,差异具有显著统计学意义[(18.63±5.20) mm vs (25.14±6.33) mm、(1.89±0.58) mm vs (2.75±0.74) mm;P=0.000、0.000];恶性组与良性组患者腔壁均匀、腔内壁规整、腔内分隔、病灶毛刺征出现情况比较,差异均无统计学意义(P> 0.05);恶性组患者的不规则囊腔形态、腔内血管形成、病灶分叶状表现均高于良性组(P <0.05);恶性组患者的胸膜凹陷发生率低于良性组患者(P <0.05);以病理诊断结果作为判断金标准,MDCT检查鉴别诊断囊腔型肺癌与空洞型肺结核的灵敏度为85.71%,特异度为73.75%,漏诊率为14.29%,误诊率为26.25%。结论囊腔型肺癌、空洞型肺结核患者的CT影像学特征差异显著,MDCT检查对于二者的鉴别诊断具有一定的临床价值。Objective To probe the application value of multidetector CT(MDCT) in differential diagnosis of cystic lung cancer and cavitary pulmonary tuberculosis. Methods A total of 164 patients with lung disease were enrolled, which included 92 males and 72 females, aged 45-79 years old with mean age of 62.8 years old. The CT imaging data was analyzed, and the maximum diameter of lesion as well as the maximum thickness of cyst wall were recorded. The imaging features such as uniform of cavity wall, regularity of cavity wall, intracavity separation, intracavity blood vessel formation, lesion lobulation, burr sign and pleural depression were observed. The pathological results were used as gold standard to calculate diagnostic sensitivity, specificity, missed diagnosis rate, misdiagnosis rate and other related diagnostic indicators of MDCT. Results According to different nature of lesions, all of them were divided into malignant group(n = 84, lung cancer with thin-walled cyst) and benign group(n = 80, cavitary pulmonary tuberculosis). The maximum diameter of lesion and maximum thickness of cyst wall were statistically significantly lower in malignant group than those in benign group[(18.63 ± 5.20) mm vs(25.14 ± 6.33) mm,(1.89 ± 0.58) mm vs(2.75 ± 0.74) mm;P = 0.000, 0.000]. There was no statistically significant difference in uniform cavity wall,regular cavity wall, intracavitary partition, and lesion burr sign between 2 groups(P > 0.05). The irregular cyst shape, intraluminal vessel formation, and lobular appearance of lesion in malignant group were significantly higher than those in benign group(P < 0.05). The incidence of pleural depression in malignant group was significantly lower than that in benign group(P < 0.05).Compared with pathological diagnosis results, the sensitivity, specificity, missed diagnosis rate and misdiagnosis rate of MDCT in differential diagnosis of cystic lung cancer and cavitary tuberculosis were 85.71 %, 73.75 %, 14.29 %, and 26.25 %, respectively. Conclusion It is demonstrated that there are

关 键 词：多层CT 囊腔型肺癌 空洞型肺结核 鉴别诊断 

分 类 号：R521[医药卫生—内科学] R734.2[医药卫生—临床医学]