多层螺旋CT、IVIM-DWI结合血清CEA、SCCA对肺炎性假瘤、周围型肺癌的诊断价值  

Diagnostic value of multi-slice CT,IVIM-DWI combined with serum CEA and SCCA in pulmonary inflammatory pseudotumor and peripheral lung cancer

作　　者：堵红群 殷允娟 邢炯 王均干 刘群 DU Hongqun;YIN Yunjuan;XING Jiong;WANG Jungan;LIU Qun(Department of Medical Imaging,the Affiliated Hospital of Jiangnan University,Wuxi,Jiangsu Province 214000,China)

机构地区：[1]江南大学附属医院医学影像科,江苏无锡214000

出　　处：《实用放射学杂志》2022年第7期1078-1081,共4页Journal of Practical Radiology

基　　金：江苏省自然基金青年科技人才专项项目(BK201602127)。

摘　　要：目的探究多层螺旋CT(MSCT)、体素内不相干运动扩散加权成像(IVIM DWI)结合血清癌胚抗原(CEA)、鳞状细胞癌相关抗原(SCCA)对肺炎性假瘤(PIP)、周围型肺癌(PLC)的鉴别诊断价值。方法回顾性分析经手术后病理证实的24例PIP患者(PIP组)和26例PLC患者(PLC组)的临床与影像资料。所有患者术前均行MSCT、IVIM-DWI及血清CEA、SCCA检查。比较2组各检查指标的差异。探讨单独以及联合诊断PLC的诊断效能。结果PLC组的平直征比例、假性扩散系数(D*)值及血清CEA、SCCA水平显著低于PIP组(P<0.05),PLC组的分叶征、毛刺征、血管集束征、胸膜凹陷征等MSCT征象比例、标准表观扩散系数(sADC)值、真性扩散系数(D)值显著高于PIP组(P<0.05);而2组间灌注分数(f)值的差异无统计学意义(P>0.05)。MSCT、IVIM-DWI结合血清CEA、SCCA诊断PLC的准确性、敏感度、特异度、阳性预测值以及阴性预测值最高(P<0.05)。结论MSCT、IVIM-DWI结合血清CEA、SCCA对PLC的诊断效能最优,对临床更有指导价值。Objective To explore the value of multi-slice CT(MSCT),intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)combined with serum carcinoembryonic antigen(CEA)and squamous cell carcinoma associated antigen(SCCA)in the dfferential diagnosis of pulmonary inflammatory pseudotumor(PIP)and peripheral lung cancer(PLC).Methods The clinical and imaging data of 24 patients with PIP(PIP group)and 26 patients with PLC(PLC group)confrmed by post-surgery pathology were analyzed retrospectively.All patients underwent MSCT,IVIM-DWI,serum CEA and SCCA before operation,and the differences between the two groups were compared to explore the diagnostic efficacy of single and combined methods in diagnosing PLC.Results The proportion of straight sign,D'value,serum CEA level and SCCA level in PLC group were significantly lower than those in PIP group(P<0.05).The proportion of MSCT signs,such as lobulation sign,spiculation sign,vessel convergence sign and pleural indentation sign,standard apparent diffusion coefficient(sADC)value and D value in PLC group were significantly higher than those in PIP group(P<0.05).There was no significant difference in f value between the two groups(P>0.05).MSCT,IVIM-DWI combined with serum CEA and SCCA had the highest accuracy,sensitivity,specificity,positive predictive value and negative predictive value in the diagnosis of PLC(P<0.05).Conclusion MSCT,IVIM-DWI combined with serum CEA and SCCA have the best diagnostic efficacyfor PLC andgive more guiding value for clinic.

关 键 词：计算机体层成像 体素内不相干运动扩散加权成像 癌胚抗原 鳞状细胞癌相关抗原 肺炎性假瘤 周围型肺癌 

分 类 号：R814.42[医药卫生—影像医学与核医学] R445.2[医药卫生—放射医学] R734.2[医药卫生—临床医学]