基于CT灌注成像的影像组学对良、恶性孤立性肺结节的鉴别诊断价值  

Value of CT Perfusion Imaging in the Differential Diagnosis of Benign and Malignant Solitary Pulmonary Nodules

作　　者：陶兴 杨文魁[2] 赵春梅[1] 张瑞博 TAO Xing;YANG Wenkui;ZHAO Chunmei;ZHANG Ruibo(Department of Radiology,the Second People's Hospital of Zhengzhou,Zhengzhou 450006,China;Department of Medical Imaging,Zhengzhou People's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第二人民医院放射影像科,河南郑州450006 [2]郑州人民医院医学影像科,河南郑州450000

出　　处：《河南医学研究》2025年第2期344-347,共4页Henan Medical Research

基　　金：河南省中医药科学研究专项课题(2019JDZX2124)。

摘　　要：目的探讨基于CT灌注成像影像组学对鉴别诊断良、恶性孤立性肺结节的价值。方法回顾性分析2021年1月至2023年2月在郑州市第二人民医院、郑州人民医院接受CT检查的200例孤立性肺结节患者的临床资料,依据手术后病理及穿刺活检病理结果,分为恶性组(100例)和良性组(100例)。比较两组患者CT灌注成像定性征象,评估CT灌注成像影像组学在鉴别诊断良、恶性孤立性肺结节中的价值。结果CT灌注成像影像组学鉴别诊断良、恶性孤立性肺结节的准确率为87.50%,敏感度为85.00%,特异度为90.00%,阳性预测值为89.47%,阴性预测值为85.71%。恶性孤立性肺结节组灌注值(AV)、灌注时间(AT)、血流量(BF)、血容量(BV)高于良性孤立性肺结节组(P<0.05);两组达峰时间(TTP)、峰值灌注值(TP)比较,差异无统计学意义(P>0.05)。结合ROC曲线分析,CT灌注参数(AV、AT、BV、BF)的AUC值>0.70。结论基于CT灌注成像影像组学对鉴别诊断良、恶性孤立性肺结节具有一定的价值,可以提高鉴别诊断的准确性和可靠性,对于指导临床治疗和预后评估具有重要意义。Objective To investigate the value of CT perfusion imaging in the differential diagnosis of benign and malignant solitary pulmonary nodules.Methods The clinical data of 200 patients with solitary pulmonary nodules who received CT examination in the Second People's Hospital of Zhengzhou and Zhengzhou People's Hospital from January 2021 to February 2023 were retrospectively analyzed,and were divided into malignant group(100 cases)and benign group(100 cases)according to postoperative pathology and biopsy pathology results.CT perfusion imaging was compared between the two groups to evaluate the value of CT perfusion imaging in the differential diagnosis of benign and malignant solitary pulmonary nodules.Results The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of CT perfusion imaging were 87.50%,85.00%,90.00%,89.47%and 85.71%respectively.Average perfusion value(AV),perfusion time(AT),blood flow(BF)and blood volume(BV)in the malignant solitary pulmonary nodule group were higher than those in the benign solitary pulmonary nodule group(P<0.05).There was no significant difference in time to peak(TTP)and peak perfusion value(TP)between the two groups(P>0.05).Combined with receiver operating characteristic(ROC)curve analysis,the area under curve(AUC)values of CT perfusion parameters(AV,AT,BV,BF)were>0.70.Conclusion CT perfusion imaging is valuable in the differential diagnosis of benign and malignant solitary pulmonary nodules,which can improve the accuracy and reliability of differential diagnosis,and is of great significance for guiding clinical treatment and prognosis evaluation.

关 键 词：孤立性肺结节 CT灌注成像 影像组学 鉴别诊断 

分 类 号：R730.44[医药卫生—肿瘤]