64层螺旋CT形态学特征与CT灌注成像定量参数对肺结节良恶性的诊断价值  

Correlation between 64-slice spiral quantitative CT imaging features and benign and malignant pulmonary nodules

作　　者：王宇[1] 褚杨 Wang Yu;Chu Yang(Department of Respiratory,Central Medical Branch of PLA General Hospital,Beijing 100081,China;不详)

机构地区：[1]中国人民解放军总医院京中医疗区呼吸科,北京100081 [2]中国人民解放军总医院京西医疗区口腔科

出　　处：《山西医药杂志》2022年第4期390-393,共4页Shanxi Medical Journal

摘　　要：目的分析64层螺旋CT对肺结节良恶性诊断价值。方法回顾性分析127例经病理证实的肺结节患者,根据病理结果分为良性肺结节(良性组)91例,早期肺癌(恶性组)36例,患者均行64层螺旋CT常规扫描及CT灌注成像,记录患者CT形态学特征、CT灌注成像参数[血流量(BF)、血容积(BV)、通透性(PMB)、平均通过时间(MTT)],应用ROC曲线确定临界值,评价CT定性指标及定量指标对早期肺癌的诊断价值。结果恶性组肺结节深分叶征、细小毛刺征、棘突征、空泡征、血管集束征检出率均明显高于良性组(P<0.05);恶性组CT灌注参数中BF、BV、PMB、MTT水平均较良性组明显升高(P<0.05);BF、BV、PMB、MTT诊断早期肺癌的ROC曲线下面积分别为0.781、0.702、0.916、0.841,对应诊断临界值分别为68.65 ml/(100 ml/min)、5.75ml/100 ml、8.90 ml/(100 ml/min)、7.95 s。以病理诊断结果为金标准,CT定性指标诊断早期肺癌的灵敏度、特异度、准确度分别为0.722、0.945、0.882,CT灌注成像定量指标的灵敏度、特异度和准确度分别为0.861、0.813、0.827,二者联合诊断的灵敏度、特异度和准确度分别为0.972、0.791、0.843。结论 64层螺旋CT形态学特征及CT灌注成像定量参数对肺结节良恶性均有一定诊断价值,且二者联合检查能提高早期肺癌诊断灵敏度。Objective To analyze the clincal value of 64-slice spiral CT in the diagnosis of benign and malignant pulmonary nodules.Methods A total of 127 patients with pulmonary nodules confirmed by pathology were retrospectively analyzed.According to the pathological results,the patients were divided into benign group(benign pul-monary nodules,91 cases) and malignant group(early lung cancer,36 cases).All patients underwent 64-slice spiral CT routine scan and CT perfusion imaging.The CT morphological features and CT perfusion imaging parameters[blood flow(BF),blood volume(BV),permeability(PMB),mean transit time(MTT)] were recorded among the patients.ROC curve was used to determine the critical value,and the value of CT qualitative indicators and quantitative indica-tors in the diagnosis of early lung cancer was evaluated.Results The detection rates of deep lobulated sign,small spiculated sign,spinous process sign,vacuole sign and vessel convergence sign of pulmonary nodules in malignant group were significantly higher than those in benign group(P<0.05).The levels of CT perfusion parameters of BF,BV,PMB and MTT in malignant group were significantly higher than those in benign group(P<0.05).The areas under the ROC curves of BF,BV,PMB and MTT in the diagnosis of early lung cancer were 0.781,0.702,0.916 and 0.841,and the corresponding diagnostic cut-off values were 68.65 ml/(100 ml/min),5.75 ml/100 ml,8.90 ml/(100 ml/min) and7.95 s,respectively.Taking pathological diagnosis results as the gold standard,the sensitivity,specificity and accuracy of CT qualitative indicators in the diagnosis of early lung cancer were 0.722,0.945 and 0.882,while 0.861,0.813 and0.827 for the quantitative indicators,and 0.972,0.791 and 0.843 for combined diagnosis of the two indicators.Conclusion The morphological features of 64-slice spiral CT and the quantitative parameters of CT perfusion imaging have certain diagnostic value on benign and malignant pulmonary nodules,and the combined examination of these two methods can improve the diagnostic sensi

关 键 词：孤立性肺结节 体层摄影术 螺旋计算机 灌注成像 诊断 

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