增强多层螺旋CT扫描在肺癌与结核致单侧全肺不张鉴别诊断应用价值  

Enhanced multislice spiral CT scan in the differential diagnosis of unilateral atelectasis caused by lung cancer and tuberculosis

作　　者：冯均良 骆玉辉 张远鸿 滕录霞 黄祥辉 Feng Junliang;Luo Yuhui;Zhang Yuanhong;Teng Luxia;Huang Xianghui(Imaging Center,Heshan People's Hospital,Guangdong529700,China)

机构地区：[1]广东省鹤山市人民医院影像中心,529700

出　　处：《实用医学影像杂志》2021年第5期445-448,共4页Journal of Practical Medical Imaging

基　　金：广东省江门市卫生健康局科学技术项目(20A216)。

摘　　要：目的研究增强多层螺旋CT扫描在肺癌与结核致单侧全肺不张中的鉴别诊断应用价值。方法将医院从2018年4月10日至2020年2月15日收治的91例单侧全肺不张患者纳入研究。将其按照病因的差异分作肺癌组(肺癌致单侧全肺不张)51例和结核组(结核致单侧全肺不张)40例。对所有受试者均开展增强多层螺旋CT扫描,比较两组受试者CT直接征象以及间接征象的差异。并以病理诊断为金标准,分析增强多层螺旋CT扫描诊断鉴别肺癌与结核致单侧全肺不张的效能。结果观察组患侧主支气管不均匀狭窄或闭塞人数占比低于对照组,而截断人数占比高于对照组(χ^(2)=29.324,29.979;P<0.01);观察组患侧肺门血无明显改变人数占比低于对照,而肺动脉不均匀变细以及肺门血管闭塞人数占比高于对照组(χ^(2)=40.663,21.412,10.841;P<0.01);观察组患侧肺门-纵隔脂肪间隙征象模糊任何数占比低于对照组,而征象消失人数占比高于对照组(χ^(2)=23.605,40.999;P<0.01)。观察组患侧胸廓塌陷、不张肺内支气管扩张、不张肺组织内钙化灶人数占比以及纵隔患侧移位均低于对照组,而纵隔最大淋巴结短径高于对照组(χ^(2)=13.130,11.245,30.350;P<0.01);观察组不张肺内支气管内容物为气相人数占比低于对照组,内容物模糊人数占比高于对照组(χ^(2)=10.028,8.811;P<0.01);观察胸膜呈结节状或不均匀增厚、轻微增厚人数占比均高于对照组,呈明显增厚且有钙化人数低于对照组(χ^(2)=15.226,15.169,54.270;P<0.01);观察组无胸腔积液人数占比低于对照组,而大量胸腔积液人数占比高于对照组(χ^(2)=34.808,18.293;P<0.01)。以病理诊断结果为金标准,增强多层螺旋CT扫描诊断鉴别肺癌致单侧全肺不张的灵敏度、特异度以及准确度分别为96%(49/51)、98%(39/40)、97%(88/91)。结论增强多层螺旋CT扫描在肺癌与结核致单侧全肺不张中的鉴别诊断应用价值较高,值得�Objective To study the value of enhanced multislice spiral CT in the differential diagnosis of unilateral atelectasis caused by lung cancer and tuberculosis.Methods A total of 91 patients with unilateral atelectasis admitted to our hospital from April 10,2018 to February 15,2020 were included in this study.According to the difference of etiology,they were divided into lung cancer group(51 cases)and tuberculosis group(40 cases).Enhanced MSCT was performed on all subjects,and the differences of direct and indirect CT signs between the two groups were compared.Based on the gold standard of pathological diagnosis,the efficacy of enhanced MSCT in the diagnosis and differentiation of unilateral atelectasis caused by lung cancer and tuberculosis was analyzed.Results:The proportion of patients with uneven bronchial stenosis or occlusion in the observation group was lower than that in the control group,while the proportion of patients with truncation was higher than that in the control group(χ^(2)=29.324,29.979;P<0.01);The proportion of patients in the observation group was lower than that in the control group,but the proportion of patients in the observation group was higher than that in the control group(χ^(2)=40.663,21.412,10.841;P<0.01);The proportion of ambiguous signs in hilar-mediastinal fat space on the affected side in observation group was lower than that in control group,while the proportion of disappeared signs was higher than that in control group(χ^(2)=23.605,40.999;P<0.01).The observation group was lower than the control group in terms of thoracic collapse,bronchiectasis in atelectasis,calcification in atelectasis and displacement in mediastinum,while the maximum short diameter of mediastinal lymph nodes was higher than that in the control group(χ^(2)=13.130,11.245,30.350;P<0.01);The proportion of gas phase in the atelectasis bronchial contents in the observation group was lower than that in the control group,and the proportion of fuzzy contents in the observation group was higher than that in the contr

关 键 词：肺肿瘤 结核 肺不张 图像增强 诊断价值 

分 类 号：R734.2[医药卫生—肿瘤] R521[医药卫生—临床医学] R563.4