胸部高分辨CT导航联合支气管镜在肺外周结节诊断中的应用  

Application of thoracic high resolution CT navigation combined with bronchoscopy in peripheral pulmonary nodules

作　　者：章志俊 潘冬青 夏贤斌 ZHANG Zhi-jun;PAN Dong-qing;XIA Xian-bin(Xinyu People's Hospital of Jiangxi Province,Xinyu 338000,Jiangxi)

机构地区：[1]新余市人民医院,江西新余338000

出　　处：《安徽医专学报》2024年第5期21-23,共3页Journal of Anhui Medical College

基　　金：新余市科技计划项目(编号:20223090885)。

摘　　要：目的:探讨胸部高分辨CT导航联合支气管镜在肺外周结节诊断中的应用价值。方法:收集医院收治的102例影像学提示肺外周结节的患者,由肺结节小组成员综合分析,对患者做常规评估后,到影像中心行胸部高分辨CT平扫+增强,根据影像学检查结果,制定经支气管镜肺活检的路径。同内镜中心联系,安排次日行支气管镜检查,追踪病理结果回报情况及疾病诊治情况。结果:病理学诊断肺外周结节结果显示,102例肺外周结节患者中,67例阳性(肺癌),35例阴性(肺炎性结节),胸部高分辨CT导航联合支气管镜诊断肺外周结节的结果与病理学诊断的一致性Kappa值为0.849。胸部高分辨CT导航联合支气管镜诊断的灵敏度为94.03%、特异度为91.43%、准确度为93.14%、阴性预测值为88.89%、阳性预测值为95.45%。绘制ROC曲线发现,胸部高分辨CT导航联合支气管镜诊断肺外周结节的AUC为0.869,标准误0.03,95%CI为0.864~0.990,表明其有一定诊断价值。结论:胸部高分辨CT导航联合支气管镜在肺外周结节诊断中的应用价值较高。Objective:To investigate the application value of thoracic high resolution CT navigation combined with bronchoscopy in peripheral pulmonary nodules.Methods:A collection of 102 patients admitted to the hospital with imaging suggestive of peripheral lung nodules were collected for comprehensive analysis by members of the pulmonary nodules team.After routine evaluation,patients were sent to the imaging center for chest highresolution CT plain scan+enhancement.The path of transbronchoscopic lung biopsy was determined according to the imaging results.Contact the endoscopy center and arrange bronchoscopy the next day to track the return of pathological results and the diagnosis and treatment of diseases.Results:Pathological diagnosis of peripheral pulmonary nodules showed that among 102 patients with peripheral pulmonary nodules,67 cases were positive(lung cancer)and 35 cases were negative(pneumonic nodules).The Kappa value of the diagnosis of peripheral pulmonary nodules by high-resolution CT navigation combined with bronchoscopy was 0.849.The sensitivity of chest high resolution CT navigation combined with bronchoscopy was 94.03%,the specificity was 91.43%,the accuracy was 93.14%,the negative predictive value was 88.89%and the positive predictive value was 95.45%.ROC curve showed that the AUC of thoracic high resolution CT navigation combined with bronchoscopy in the diagnosis of peripheral pulmonary nodules was 0.869,standard error 0.03,and 95%CI was 0.864-0.990,which had certain diagnostic value.Conclusion:Thoracic high resolution CT navigation combined with bronchoscopy is of high value in the application of peripheral pulmonary nodules.

关 键 词：肺外周结节 胸部高分辨CT导航 支气管镜 

分 类 号：R563[医药卫生—呼吸系统]