强化多期动态CT增强扫描应用在孤立性肺结节诊断中的效能分析  

Efficacy Analysis of Enhanced Multi-Phase Dynamic CT Scanning in the Diagnosis of Solitary Pulmonary Nodules

作　　者：崔松伟 CUI Songwei(Department of Radiology,Jili People's Hospital of Mengjin District,Luoyang Henan 471100,China)

机构地区：[1]洛阳市孟津区吉利人民医院放射科,河南洛阳471100

出　　处：《临床研究》2025年第2期151-153,共3页Clinical Research

摘　　要：目的分析强化多期动态CT增强扫描应用在孤立性肺结节(SPN)诊断中的效能。方法选取洛阳市孟津区吉利人民医院2020年1月至2024年10月收治的81例SPN患者为对象,所有患者均行常规CT及多期动态CT增强扫描,以手术病理诊断为金标准,分析其相关数据。结果81例SPN患者中,恶性55例,良性26例。其中恶性患者包括鳞癌20例,类癌2例,小细胞癌6例,腺癌19例,支气管肺泡癌6例,大细胞癌2例。良性患者包括炎性结节15例,结核球6例,腺瘤2例,炎性肌纤维母细胞瘤2例,硬化型血管瘤1例。常规CT诊断结果为阳性47例,阴性34例,与病理诊断一致性较差(Kappa=0.068);多期动态CT增强诊断结果为阳性53例,阴性34例,与病理诊断的一致性较好(Kappa=0.897)。多期动态CT增强检查的敏感度、准确性、特异性、阳性预测值、阴性预测值均高于常规CT,差异有统计学意义(P<0.05)。多期动态CT增强扫描圆形/类圆形、不规则形、分叶、毛刺、清晰、模糊、血管集束征、胸膜凹陷征均高于常规CT,差异有统计学意义(P<0.05)。结论多期动态CT增强扫描在SPN的诊断中优于常规CT,恶性肿瘤的识别和准确性较高。临床评估SPN时,建议优先采用多期动态CT增强扫描,以提高诊断的准确性,并为后续治疗决策提供可靠依据。Objective To analyze the efficacy of enhanced multi-phase dynamic CT scanning in the diagnosis of solitary pulmonary nodules(SPN).Methods A total of 81 patients with SPN treated at Jili People's Hospital of Mengjin District from January 2020 to October 2024 were selected as study subjects.All patients underwent conventional CT and multi-phase dynamic CT enhancement scans,with surgical pathological diagnosis serving as the gold standard for analysis.Results Among the 81 SPN patients,55 were diagnosed with malignant nodules and 26 with benign nodules.Malignant cases included 20 squamous cell carcinomas,2 carcinoids,6 small cell carcinomas,19 adenocarcinomas,6 bronchial-alveolar carcinomas,and 2 large cell carcinomas.Benign cases consisted of 15 hamartomas,6 tuberculomas,2 adenomas,2 inflammatory myofibroblastic tumors,and 1 sclerosing hemangioma.Conventional CT yielded positive results in 47 cases and negative results in 34 cases,showing poor consistency with pathological diagnosis(Kappa=0.068).In contrast,the multi-phase dynamic CT enhancement resulted in 53 positive and 34 negative diagnoses,demonstrating good consistency with pathological diagnosis(Kappa=0.897).The sensitivity,accuracy,specificity,positive predictive value,and negative predictive value of multi-phase dynamic CT enhancement were all significantly higher than those of conventional CT(P<0.05).Additionally,features such as round/oval shape,irregular shape,lobulation,spiculation,clear margins,ill-defined margins,vascular clustering,and pleural indentation exhibited significantly better detection rates in multi-phase dynamic CT compared to conventional CT(P<0.05).Conclusion Multi-phase dynamic CT enhancement scanning is superior to conventional CT in the diagnosis of SPN,providing higher accuracy and reliability in identifying malignant tumors.It is recommended to prioritize the use of multi-phase dynamic CT enhancement scans in clinical assessment of SPN to improve diagnostic accuracy and provide a reliable basis for subsequent treatment decisions.

关 键 词：强化多期动态CT增强扫描 孤立性肺结节 诊断 效能分析 

分 类 号：R734.2[医药卫生—肿瘤]