纵隔淋巴结CT影像学特征对肺结节病的诊断价值  

Diagnostic value of mediastinal lymph nodes CT imaging features in pulmonary sarcoidosis

作　　者：李岳鸿 阮婷[1] 文琨 陈颖[1] 吕彦天[1] 金明华[1] 徐莉[1] 徐国鹏[1] LI Yuehong;RUAN Ting;WEN Kun;CHEN Ying;LYU Yantian;JIN Minghua;XU Li;XU Guopeng(Department of Respiratory and Critical Care Medicine,Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou,Jiangsu 215000,China)

机构地区：[1]南京医科大学附属苏州医院呼吸与危重症医学科,江苏苏州215000

出　　处：《重庆医学》2025年第1期168-171,共4页Chongqing Medical Journal

摘　　要：目的探讨纵隔淋巴结CT影像学特征对肺结节病的诊断价值。方法回顾性分析2015年6月至2023年11月于该院经超声内镜引导下支气管镜针吸活检(EBUS-TBNA)证实的肺结节病(肺结节病组)及肺癌伴纵隔淋巴结转移(肺癌组)患者的临床资料。所有病例行胸部平扫CT及增强CT,比较两组患者影像学特征。绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),分析相关指标对肺结节病的诊断价值。结果肺结节病组女性患者比例明显高于肺癌组,年龄小于肺癌组,差异有统计学意义(P<0.05)。肺结节病组纵隔淋巴结数、位置、短径、CT强化值比较差异有统计学意义(P<0.05)。ROC曲线分析显示,单独检测纵隔淋巴结短径倒数、CT强化值及位置的AUC分别为0.586、0.785、0.505,三者联合倒数的AUC最高(0.789)。结论淋巴结短径、CT强化值和位置在临床诊断肺结节病方面具有一定的价值,3项指标联合可提高肺结节病的诊断效能。Objective To explore the diagnostic value of mediastinal lymph nodes CT image features in pulmonary sarcoidosis.Methods The imageologic data of the patients with pulmonary sarcoidosis(pulmonary sarcoidosis group)and lung cancer complicating mediastinal lymph node metastasis(lung cancer group)confirmed by EBUS-TBNA in this hospital from June 2015 to November 2023 were analyzed retrospectively.The chest plain scan CT and enhanced scan CT were performed in all cases,and the imaging characteristics were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated.The diagnostic value of CT imaging characteristics in pulmonary sarcoidosis was analyzed.Results The proportion of female patients in the lung sarcoidosis group was significantly higher than that in the lung cancer group,while the age was smaller than that in the lung cancer group,and the differences were statistically significant(P<0.05).The number of mediastinal lymph nodes,location,short diameter and CT enhancement value in the pulmonary sarcoidosis group had statistical difference(P<0.05).The ROC curve analysis showed that AUC of lymph node short diameter reciprocal,CT enhancement value and position in detection alone were 0.586,0.785 and 0.505 respectively,and AUC of the three combined reciprocal was the highest(0.789).Conclusion The lymph node short diameter,CT enhancement value and position have certain value in clinical diagnosis of pulmonary sarcoidosis and the 3-indicator combination could increase the diagnostic efficiency of pulmonary sarcoidosis.

关 键 词：肺结节病 诊断 CT 强化值 肺癌 

分 类 号：R564[医药卫生—呼吸系统]