多层螺旋CT结合胸水尾加压素Ⅱ对结核性与恶性胸腔积液的鉴别效能分析  

MSCT combined with pleural effusion urotensinⅡin differentiating tuberculous and malignant pleural effusion

作　　者：徐建军 范路艳 XU Jianjun;FAN Luyan(Department of Imaging,Gongyi People's Hospital,Zhengzhou,Henan 451250,China)

机构地区：[1]巩义市人民医院影像科,河南郑州451250

出　　处：《中国医学工程》2023年第8期115-119,共5页China Medical Engineering

摘　　要：目的探讨多层螺旋CT(MSCT)结合胸水尾加压素Ⅱ(UⅡ)对结核性与恶性胸腔积液的鉴别效能。方法回顾性分析巩义市人民医院2019年10月至2022年11月收治的46例恶性胸腔积液患者(恶性组)与59例结核性胸腔积液患者(结核组)的临床资料。纳入研究者均行MSCT检查及胸水UⅡ水平检测。对比恶性组、结核组MSCT影像学特点以及胸水UⅡ水平。分析MSCT鉴别诊断恶性与结核性胸腔积液的价值。采用受试者工作特征(ROC)曲线分析胸水UⅡ水平对恶性与结核性胸腔积液的鉴别诊断价值。比较MSCT、胸水UⅡ水平单独与联合对恶性与结核性胸腔积液的鉴别效能。结果恶性组CT值与结核组比较差异无统计学意义(P>0.05),恶性组中大量积液、纵隔移位、胸膜弥漫性或局限性增厚、增强扫描明显强化、支气管狭窄或阻塞的占比均高于结核组(P<0.05),恶性组中胸膜钙化、包裹性积液占比低于结核组(P<0.05);恶性组胸水UⅡ水平高于结核组(P<0.05);MSCT检查鉴别诊断恶性与结核性胸腔积液的灵敏度、特异度、准确度、阳性预测值、阴性预测值、Youden指数分别为82.61%、84.75%、83.81%、80.85%、86.21%、0.6736;经ROC曲线分析,胸水UⅡ水平鉴别诊断恶性与结核性胸腔积液的最佳截断点为19.51 ng/mL,灵敏度、特异度分别为65.22%、88.14%,曲线下面积(AUC)为0.787,Youden指数为0.5336,准确度、阳性预测值、阴性预测值分别为78.10%、81.08%、76.47%;MSCT检查联合胸水UⅡ水平鉴别诊断恶性与结核性胸腔积液的灵敏度、特异度、准确度、阳性预测值、阴性预测值、Youden指数分别为97.83%、84.75%、90.48%、83.33%、98.04%、0.8258;MSCT检查联合胸水UⅡ水平鉴别诊断恶性与结核性胸腔积液的灵敏度、阴性预测值均高于MSCT检查、胸水UⅡ水平单独诊断(P<0.05),且联合诊断的准确度高于胸水UⅡ水平单独诊断(P<0.05)。结论MSCT检查、胸水UⅡ水平检测均【Objective】To explore the differential efficacy of multi-slice spiral CT(MSCT)combined with urotensinⅡ(UII)in the diagnosis of tuberculous and malignant pleural effusion.【Methods】The clinical data of 46 patients with malignant pleural effusion(malignant group)and 59 patients with tuberculous pleural effusion(tuberculosis group)admitted to our hospital from October 2019 to November 2022 were analyzed retrospectively.All the included researchers were examined by MSCT and UII level of pleural effusion was detected.The MSCT imaging characteristics and UII level of pleural effusion between malignant group and tuberculosis group were compared.The value of MSCT in differential diagnosis of malignant and tuberculous pleural effusion was analyzed.The value of UII level of pleural effusion in differential diagnosis of malignant and tuberculous pleural effusion was analyzed by receiver operating characteristic(ROC)curve.The differential efficacy of MSCT and pleural effusion UII level alone and in combination for malignant and tuberculous pleural effusion was compared.【Results】There was no significant difference in CT value between malignant group and tuberculosis group(P>0.05),and the proportions of massive effusion,mediastinal displacement,diffuse or localized pleural thickening,obvious enhancement after enhanced scanning,bronchial stenosis or obstruction in the malignant group were higher than those in the tuberculosis group(P<0.05),but the proportions of pleural calcification and encapsulated effusion in the malignant group were lower than those in the tuberculosis group(P<0.05).The level of pleural effusion UII in malignant group was higher than that in tuberculosis group(P<0.05).The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Youden index of MSCT in differential diagnosis of malignant and tuberculous pleural effusion were 82.61%,84.75%,83.81%,80.85%,86.21%and 0.6736 respectively.The ROC curve analysis showed that the best cut-off point for the differential diag

关 键 词：多层螺旋CT 尾加压素Ⅱ 胸腔积液 积液性质 鉴别效能 

分 类 号：R561.3[医药卫生—呼吸系统]