胸部CT值在胸腔积液鉴别诊断的价值  

Application of the chest CT value in differential diagnosis of pleural effusion

作　　者：吕晋 张棪 莫泽珣 孙诚 郭伟鸿 黄晓梅 魏树全 赵子文[2,3] 陈立鹏 李裕军[2,3] LV Jin;ZHANG Yan;MO Zexun;SUN Cheng;GUO Weihong;HUANG Xiaomei;WEI Shuquan;ZHAO Ziwen;CHEN Lipeng;LI Yujun(Department of Radiology,Guangzhou First People􀆳s Hospital,School of Medicine,South China University of Technology,Guangzhou 510180,China;Department of Pulmonary and Critical Care Medicine,Guangzhou First People􀆳s Hospital,School of Medicine,South China University of Technology,Guangzhou 510180,China;Multi-Disciplinary Team(MDT)for Management of Pleural Effusion and Pleural Diseases,Guangzhou First People􀆳s Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院/华南理工大学附属第二医院放射科,广州510180 [2]广州市第一人民医院/华南理工大学附属第二医院呼吸与危重症医学科,广州510180 [3]广州市第一人民医院胸腔积液和胸膜疾病规范化诊治多学科团队(MDT),广州510180

出　　处：《广州医药》2023年第2期38-41,共4页Guangzhou Medical Journal

摘　　要：目的探索胸部CT值在胸腔积液鉴别诊断的价值。方法81例胸腔积液患者纳入本研究,胸腔积液分为渗出液、漏出液、恶性胸腔积液及良性胸腔积液。建立平均CT值的ROC曲线,计算曲线下面积。结果81例胸腔积液患者中59例为渗出液,22例为漏出液;恶性胸腔积液33例,良性胸腔积液48例。渗出液组平均CT值(16.68±6.76)Hu高于漏出液组(5.50±3.42)Hu(P<0.0001)。ROC曲线分析结果显示,胸腔积液平均CT值对区分渗出液和漏出液具有较高的准确性(曲线下面积为0.9445)。当最佳界值为≥9.99 Hu时,其敏感度为88.14%,特异度为90.91%;恶性胸腔积液组平均CT值(15.38±7.29)Hu与良性胸腔积液组平均CT值(12.45±8.03)Hu没有差异(P=0.0981)。结论在胸腔积液的鉴别诊断过程中,胸部CT的CT值在鉴别漏出液及渗出液中有一定的价值,但尚不能用于鉴别良性及恶性胸腔积液。Objective To explore the value of chest CT value in the differential diagnosis of pleural effusion.Methods A total of 81 patients with pleural effusion were included in this study,including exudate,transudate,malignant pleural effusion and benign pleural effusion.The ROC curve of average CT value was established and the area under the curve was calculated.Results Among 81 patients with pleural effusion,59 cases were exudative,22 cases were transudative,33 cases were malignant pleural effusion and 48 cases were benign pleural effusion.The mean CT value of the exudate group,(16.68±6.76)Hu,was significantly higher than(5.50±3.42)Hu of the transudate group(P<0.0001).ROC curve analysis showed that the mean CT value of pleural effusion had high accuracy in distinguishing exudate from transudate(area under the curve was 0.9445).When the cut-off value for exudative effusion was over 9.99 Hu,the sensitivity and specificity were 88.14%and 90.91%,respectively.The mean CT value of malignant pleural effusion group,(15.38±7.29)Hu,was not significantly different from(12.45±8.03)Hu of benign pleural effusion group(P=0.0981).Conclusions In the differential diagnosis of pleural effusion,the chest CT value can be used to identify transudate and exudate,but not benign and malignant pleural effusion.

关 键 词：胸腔积液 CT值 鉴别诊断 

分 类 号：R561.3[医药卫生—呼吸系统] R816.4[医药卫生—内科学]