Lung-RADS与CT联合诊断恶性SPN的临床意义  

Clinical Significance of Lung-RADS Combined with CT in the Diagnosis of Malignant SPN

作　　者：李琪 李丰章 刘天笑 LI Qi;LI Fengzhang;LIU Tianxiao(Department of Imaging,Pingxiang People's Hospital,Pingxiang 337000,China;不详)

机构地区：[1]萍乡市人民医院影像科,江西萍乡337000

出　　处：《中国医学创新》2024年第32期143-147,共5页Medical Innovation of China

摘　　要：目的:探究肺结节肺部影像报告与数据系统(Lung-RADS)分类联合电子计算机断层扫描(CT)诊断恶性孤立性肺结节(SPN)的价值。方法:选择2020年6月—2022年6月萍乡市人民医院收治的120例SPN患者的临床资料,经病理或手术明确24例良性SPN、96例恶性SPN;回顾性分析其肺结节Lung-RADS分类及CT影像检查结果,采用受试者操作特征(ROC)曲线分析Lung-RADS分类、CT征象评分单独及联合诊断恶性SPN的效能。结果:120例患者Lung-RADS分类结果显示,2类16例,3类20例,4A类10例,4B类54例,4C类20例。良性SPN组病灶边界光整、钙化占比均高于恶性SPV组,支气管截断、胸膜牵拉、分叶、肿瘤血管征象占比均低于恶性SPN组,差异均有统计学意义(P<0.05)。良性SPN组CT征象评分2分患者占比高于恶性SPN组,恶性SPN组CT征象4、5、6分患者占比均高于良性SPN组,差异均有统计学意义(P<0.05)。ROC曲线分析显示,Lung-RADS分类、CT征象评分联合诊断恶性SPN的AUC值为0.948,高于二者单独诊断的0.881、0.931,联合诊断恶性SPN的敏感度为97.92%,高于lung-RADS分类、CT征象评分单独诊断的83.33%、89.58%。结论:Lung-RADS分类与CT征象联合诊断恶性SPN较二者单独诊断具备更高诊断效能,可提升恶性SPN诊断敏感度,具有良好的临床应用价值。Objective:To explore the value of lung imaging-report and data system(Lung-RADS)classification combined with computed tomography(CT)in the diagnosis of malignant solitary pulmonary nodule(SPN).Method:Clinical data of 120 patients with SPN treated in Pingxiang People's Hospital from June 2020 to June 2022 were selected.There were 24 cases of benign SPN and 96 cases of malignant SPN that confirmed by pathology or surgery.The Lung-RADS classification of lung nodules and the results of CT imaging were retrospectively analyzed.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of Lung-RADS classification and CT sign score in the diagnosis of malignant SPN alone and in combination.Result:The results of Lung-RADS classification of 120 patients showed,16 cases in class 2,20 cases in class 3,10 cases in class 4A,54 cases in class 4B,and 20 cases in class 4C.The proportion of lesion boundary finishing,calcification in benign SPN group were higher that those in malignant SPN group,bronchial truncation,pleural stretch,lobulation and tumor vascular signs in benign SPN group were lower than those in malignant SPN group,the differences were statistically significant(P<0.05).The proportion of patients with CT signs score of 2 in benign SPN group was higher than that in malignant SPN group,and the proportion of patients with CT signs score of 4,5 and 6 in malignant SPN group were higher than those in benign SPN group,the differences were statistically significant(P<0.05).ROC curve analysis showed that the AUC value of Lung-RADS classification combined with CT signs score in the diagnosis of malignant SPN was 0.948,which was higher than 0.881 and 0.931 respectively,the sensitivity of combined diagnosis of malignant SPN was 97.92%,which was higher than 83.33%and 89.58%of Lung-RADS classification and CT sign score alone.Conclusion:The combination of Lung-RADS classification and CT signs in the diagnosis of malignant SPN has higher diagnostic efficiency than the two diagnoses alone,and can improve the diagno

关 键 词：孤立性结节 肺部影像报告与数据系统 CT征象 

分 类 号：R563[医药卫生—呼吸系统] R816.41[医药卫生—内科学]