探讨多层螺旋CT动态增强成像在诊断肺部孤立性结节中的临床意义  

Clinical Significance of Multilayer Spiral CT Dynamic Enhancement Imaging in the Diagnosis of Solitary Pulmonary Nodules

作　　者：齐燕辉[1] QI Yan-hui(Radiology Department,Tianjin Public Security Hospital,Tianjin,300042,China)

机构地区：[1]天津市公安医院放射科,天津300042

出　　处：《黑龙江医学》2023年第9期1084-1086,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨多层螺旋CT动态增强成像在诊断肺部孤立性结节(SPN)中的应用价值。方法:选择2017年2月—2020年2月天津市公安医院收治的64例SPN患者。所有患者均行多层螺旋CT动态增强成像检查,以病理结果为判断金标准,评价CT动态增强成像诊断效能,分析多层螺旋CT动态增强成像诊断结果与病理结果的一致性,另分析良、恶性SPN患者的CT征象和不同时间点动态增强CT值。结果:经穿刺活检或手术病理证实恶性SPN患者30例、良性SPN患者34例;多层螺旋CT动态增强成像诊断出恶性SPN患者29例、良性SPN患者35例;多层螺旋CT动态增强成像诊断SPN的灵敏度、特异度、准确度为90.00%(27/30)、94.12%(32/34)、92.19%(59/60);多层螺旋CT动态增强成像诊断结果与病理结果的一致性良好,差异有统计学意义(Kappa=0.843,P<0.001)。良性SPN患者圆形/类圆形占比5.88%、支气管充气征占比11.76%、血管集束征占比0%、毛刺占比26.47%、深分叶占比2.94%、胸膜凹陷征占比5.88%、空泡征占比14.71%,低于恶性SPN患者的63.33%、83.33%、86.67%、86.67%、100%、86.67%、73.33%,差异有统计学意义(χ^(2)=23.861、32.943、49.628、23.305、60.114、42.264、22.460,P<0.05);在0 s、30 s、90 s、180 s动态增强扫描时间下,良性SPN患者CT值分别为(27.23±5.10)HU、(35.68±6.79)HU、(24.28±5.01)HU、(39.20±6.71)HU,均低于恶性SPN患者的(34.45±6.41)HU、(63.12±7.43)HU、(71.84±8.56)HU、(68.94±7.66)HU,差异有统计学意义(t=5.013、15.436、27.511、16.559,P<0.05)。结论:多层螺旋CT动态增强成像能够明晰良、恶性SPN患者的CT征象和不同时间点动态增强CT值,可为鉴别诊断良、恶性SPN提供有利证据。Objective:To investigate the value of multilayer spiral CT dynamic enhancement imaging in the diagnosis of solitary pulmonary nodules(SPN).Methods:64 patients with SPN admitted to the hospital from February 2017 to February 2020 were selected,and all patients underwent multilayer spiral CT dynamic enhancement imaging.Pathological findings were used as the gold standard for judgment,CT dynamic-enhanced imaging diagnostic efficacy was evaluated,and multilayer spiral CT dynamic-enhanced imaging diagnostic findings were analyzed in agreement with pathological findings,and CT signs and dynamic-enhanced CT values at different time points in patients with benign and malignant SPN were additionally analyzed.Results:30 patients with malignant SPN and 34 patients with benign SPN were confirmed by puncture biopsy or surgical pathology.Multilayer spiral CT dy⁃namic enhancement imaging diagnosed 29 patients with malignant SPN and 35 patients with benign SPN.The sensitivity,specificity,and accuracy of multilayer spiral CT dynamic enhancement imaging for the diagnosis of SPN were 90.00%(27/30),94.12%(32/34),and 92.19%(59/60).The diagnostic results of multilayer spiral CT dynamic enhancement imaging were in good agreement with the pathological findings,with statistically significant differences(Kappa=0.843,P<0.001).The percentages of round/round-like in benign SPN patients were 5.88%,bronchial inflation sign was 11.76%,vascular collection sign was 0,burr was 26.47%,deep lobu⁃lation was 2.94%,pleural depression sign was 5.88%,and vacuolation sign was 14.71%,which were lower than 63.33%,83.33%,86.67%,86.67%,100.00%,86.67%,and 73.33%of malignant SPN patients,with statistically significant differences(χ^(2)=23.861,32.943,49.628,23.305,60.114,42.264,22.460,P<0.05).At 0 s,30 s,90 s,and 180 s dynamic enhancement scan times,the CT values of benign SPN patients were(27.23±5.10)HU,(35.68±6.79)HU,(24.28±5.01)HU,and(39.20±6.71)HU,which were lower than(34.45±6.41)HU,(63.12±7.43)HU,(71.84±8.56)HU,(68.94±7.66)HU of malignant SPN p

关 键 词：肺部孤立性结节 动态增强成像 诊断效能 

分 类 号：R445[医药卫生—影像医学与核医学]