早期CT扫描漏诊肿瘤肺转移病例特征分析  

Retrospective analysis of missed diagnosis of early lung metastase focuse on CT image

作　　者：王良文 程洁敏 王小林 WANG Liang-wen;CHENG Jie-min;WANG Xiao-lin(Department of Interventional Radiology,Zhongshan Hospital,Fudan University,Shanghai Institution of Medical Imaging,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院介入科,上海市影像医学研究所,上海200032

出　　处：《中国临床医学》2022年第1期53-57,共5页Chinese Journal of Clinical Medicine

摘　　要：目的分析CT扫描图像中早期肿瘤肺转移的漏诊情况。方法选择2016年1月至2020年1月就诊的120例肿瘤肺转移患者,分析其CT影像及病史资料。120例患者均进行了多次胸部CT检查(包括术前胸部CT检查),分析CT图像中早期肺转移灶诊断及漏诊情况,并分析原发癌类型和是否临近血管等情况。结果早期肺转移漏诊患者有42例(35%),其中单发转移21例、多发转移21例。肺部不同区域两次扫描间漏诊转移灶大小差异有统计学意义(P<0.01)。漏诊组肺转移灶与邻近血管、胸膜及叶间裂的平均距离及邻近血管的直径小于真阴性组(P<0.01)。结论CT扫描图像中出现的早期肺转移灶常被漏诊,有望通过培训及技术发展,提高CT扫描图像中出现的早期肺转移灶的诊断率,尽早发现肿瘤肺转移,进而为临床治疗方案制定提供依据。Objective To analyze missed diagnosis of early lung metastase focuse on CT image.Methods One hundred and twenty patients with lung metastases diagnosed from January 2016 to January 2020 were randomly selected,and their CT images were analyzed retrospectively.All patients had multiple CT examinations of chest,included CT examinations before surgery.The earliest CT scans were examined to determine whether diagnosed or missed early lung metastases.And the types of the primary cancer,adjacency to blood vessels or no and so on were analyzed.Results The missed lung metastases were founded in 42(35%)patients,including 21 cases of single metastasis and 21 cases of multiple metastases.There was a statistically significant difference in the average size of the missed lung metastase focuses in sub-regions between the two times of examination(P<0.01).The distances of the missed focuse to adjacency to blood vessel,pleura,and interlobular fissure was shorter in the missed group than that in the negative group(P<0.01).Conclusions The early lung metastase focuses on CT images often be missed.The rate of early lung metastase focuses that appeared on the CT images would be increased by training radiologists and technology development,so as to find the lung metastase in the early time,and provide basis for treatment of the early lung metastase.

关 键 词：计算机断层扫描 肺转移 早期 漏诊 

分 类 号：R734.2[医药卫生—肿瘤]