低剂量多层螺旋CT多平面重组技术结合平均CT值在早期周围型肺腺癌筛查中的诊断价值  

Diagnostic value study of multi-planar reconstruction of low-dose MSCT combined with mean CT value in screening early peripheral lung adenocarcinoma

作　　者：丁智 Ding Zhi(CT Room,Jujiang Third People's Hospital Jiujiang,Jiangxi 332000,China)

机构地区：[1]九江市第三人民医院CT室,江西九江332000

出　　处：《实用医技杂志》2023年第11期794-798,共5页Journal of Practical Medical Techniques

摘　　要：目的分析低剂量多层螺旋电子计算机断层扫描(MSCT)多平面重组技术结合平均CT值在早期周围型肺腺癌(PLC)筛查中的定性诊断价值。方法回顾性选取2022年12月至2023年7月九江市第三人民医院可疑肺部病变患者593例患者的临床资料,共筛查出34例患者肺部磨玻璃结节(GGN),34例患者中发现39个肺部GGN,根据病理学检查结果分为浸润前病变组(n=24)和浸润性病变组(n=15)。对所有入组患者MSCT图像进行分析,比较2组患者MSCT征象;以手术后病理组织学检查结果为金标准,分析低剂量MSCT多平面重组技术结合平均CT值对早期PLC患者浸润性病变情况诊断效能。结果浸润前病变组与浸润性病变组患者病变部位、边界情况及病变形态等比较差异无统计学意义(P>0.05),在边缘情况、病灶大小及平均CT值方面差异有统计学意义(P<0.05);平均CT值诊断PLC的受试者工作特征(ROC)曲线分析显示平均CT值诊断PLC患者效能较高(P<0.05),其约登指数为0.575时,对应截断值为≤-576.27 Hu,诊断周围型肺腺癌患者曲线下面积(AUC)为0.822,敏感度、特异度分别为70.8%、86.7%;以病理检查结果为金标准,低剂量MSCT多平面重组技术联合平均CT值检查的敏感度、特异度、准确率分别为93.3%、87.5%、89.7%,阳性、阴性预测值为82.4%、95.4%,其中误诊、漏诊患者分别为3例、1例,误诊率为7.7%,漏诊率为2.6%,低剂量MSCT多平面重组技术联合平均CT值诊断早期PLC患者的Kappa值为0.788,与病理检查诊断结果一致性较高。结论低剂量MSCT多平面重组技术联合平均CT值可用于诊断早期PLC患者浸润性病变情况,对于定性诊断有重要价值。Objective To analyze the value of multiplanar reconstruction of low-dose multi-slice spiral computed tomography(MSCT)combined with mean CT value in the qualitative diagnosis of early peripheral lung adenocarcinoma(PLC).Methods The clinical data of 593 patients who were suspected of pulmonary lesions and admitted to Jiujiang Third People's Hospital from December 2022 to July 2023 were selected retrospectively.The screening results showed that 39 pulmonary ground glass nodules(GGNs)in the lungs were detected in 34 patients with GGNs.Based on pathological results,they were divided into the pre-invasive lesion group(n=24)and the invasive lesion group(n=15).MSCT signs of the two groups were analyzed and compared.With postoperative histopathological results as a control,the performance of multi-planar reconstruction of low-dose MSCT combined with mean CT value in diagnosing invasive lesions in patients with early PLC was analyzed.Results There was no significant difference in lesion location,boundary,or lesion morphology between the pre-invasive lesion group and the invasive lesion group(P>0.05),but there were significant differences in edge,lesion size and mean CT value(P<0.05).The ROC curve analysis found that the mean CT value was more effective in diagnosing patients with PLC(P<0.05).When the Youden index was 0.575,the corresponding Cut-off value was≤-576.27 Hu,and the AUC for diagnosing peripheral lung adenocarcinoma was 0.822,with sensitivity of 70.8%and specificity of 86.7%.With pathological results as the golden standard,the sensitivity,specificity,accuracy,and positive and negative predictive values of multi-planar reconstruction of low-dose MSCT combined with mean CT value were 93.3%,87.5%,89.7%,82.4%and 95.4%.The misdiagnosis rate and missed diagnosis rate were 7.7%and 2.6%.The Kappa value of multi-planar reconstruction of low-dose MSCT combined with the mean CT value for diagnosing early PLC was 0.788,which had a high consistency with pathological diagnosis.The consistency of the diagnostic results of the

关 键 词：体层摄影术 螺旋计算机 肺腺癌 周围型 癌症早期检测 

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