多层螺旋平扫及增强扫描对肺部占位病变的鉴别诊断价值分析  

Analysis of the differential diagnostic value of MSCT plain scan and enhanced scan for pulmonary space occupying lesions

作　　者：石浩 Shi Hao(Department of Imaging,Puyang Traditional Chinese Medicine Hospital,Puyang 457000,China)

机构地区：[1]濮阳市中医医院影像科,濮阳457000

出　　处：《实用医技杂志》2024年第4期271-274,共4页Journal of Practical Medical Techniques

摘　　要：目的观察多层螺旋计算机断层扫描(MSCT)与增强扫描联合用于肺部占位病变鉴别诊断的价值,提高临床肺部占位病变的检出,为合理指导临床诊疗提供科学影像参考。方法研究对象选自我院2021年10月至2022年10月期间收治的100例肺部占位性病变患者,全部患者均接受病理组织、MSCT、增强扫描检查,以病理组织检查结果为金标准,分析MSCT、增强扫描单独及联合用于肺部占位性病变鉴别诊断的价值。结果全部的肺部占位性病变患者均得到准确的病理诊断,纳入的100例患者中良性结节为13例,其余87例均为恶性。经MSCT检查结果显示,良性、恶性在卫星灶检出方面对比差异无统计学意义(P>0.05),恶性占位性病变表现为结节直径(≥1.0 cm)、磨玻璃样特征、不规则形态、边界毛糙、胸膜凹陷支气管血管集束征占比均较良性占位性病变高(P<0.05)。100例肺部占位病变经MSCT检出83例恶性,17例良性,诊断效能:灵敏度92%,特异度76.9%,准确率90.0%,阳性预测值96.4%,阴性预测值58.8%。增强扫描检出80例恶性,20例良性,诊断效能:灵敏度89.7%,特异度84.6%,准确率89.0%,阳性预测值97.5%,阴性预测值55.0%。MSCT联合增强扫描检出85例恶性,15例良性,诊断效能:灵敏度96.6%,特异度92.3%,准确率96.0%,阳性预测值98.8%,阴性预测值80.0%。绘制受试者工作特征(ROC)曲线图,结果显示MSCT诊断肺部占位性病变曲线下面积(AUC)(95%CI)=0.871(0.705,0.984),增强扫描为AUC(95%CI)=0.844(0.751,0.991),联合诊断AUC为(95%CI)=0.944(0.857,1.000),尤以联合诊断AUC最大,较各影像学单独诊断更具诊断价值。结论MSCT联合增强扫描诊断肺部占位性病变,更具诊断价值,利于提高肺部占位性病变癌变病灶的检出率。Objective To observe the value of combining multi-slice spiral computed tomography(MSCT)combined with enhanced scanning in the differential diagnosis of pulmonary space occupying lesions,in order to improve the detection of clinical pulmonary space occupying lesions and provide scientific imaging references for guiding clinical diagnosis and treatment.Methods The research subjects were selected from 100 patients with pulmonary space occupying lesions who were admitted to our hospital from October 2021 to October 2022 were selected as the research subjects.All patients underwent pathological tissue,MSCT,and enhanced scanning examinations.The pathological tissue examination results were used as the gold standard to analyze the value of MSCT and enhanced scanning alone and in combination for the differential diagnosis of pulmonary space occupying lesions.Results All patients with pulmonary space occupying lesions received accurate pathological diagnosis.Among the 100 patients included,13 were benign nodules,and the remaining 87 were malignant.The results of MSCT examination showed that there was no statistically significant difference between benign and malignant in satellite lesion detection(P>0.05).Malignant space occupying lesions were characterized by nodule diameter(≥1.0 cm),ground-glass like features,irregular morphology,rough boundaries,and pleural depression.The proportion of bronchovascular bundle sign was higher than that of benign space occupying lesions(P<0.05).MSCT detected 83 cases of malignant and 17 cases of benign lung masses in 100 cases,with diagnostic efficacy of sensitivity of 92.0%,specificity of 76.9%,accuracy of 90.0%,positive predictive value of 96.4%,and negative predictive value of 58.8%.Enhanced scanning detected 80 cases of malignancy and 20 cases of benign,with diagnostic efficacy of sensitivity of 89.7%,specificity of 84.6%,accuracy of 89.0%,positive predictive value of 97.5%,and negative predictive value of 55.0%.MSCT combined with enhanced scanning detected 85 cases of malignancy a

关 键 词：多探头的计算机断层扫描 肺肿瘤 诊断 鉴别 

分 类 号：R563[医药卫生—呼吸系统]