探究DR和MSCT对肺内炎症肿块、2cm以下周围型肺癌的鉴别诊断价值  

To Explore the Value of DR and MSCT in the Differential Diagnosis of Intrapulmonary Inflammatory Mass and Peripheral Lung Cancer Below 2cm

作　　者：姚丽清 苏小蓉 YAO Li-qing;SU Xiao-rong(Xiamen University Affiliated Zhongshan Hospital,Fujian Xiamen 361004;Xiamen Radiation Quality Control Center,Fujian Xiamen 361004)

机构地区：[1]厦门大学附属中山医院,福建厦门361004 [2]厦门市放射质量控制中心,福建厦门361004

出　　处：《中国医疗器械信息》2025年第4期8-10,91,共4页China Medical Device Information

摘　　要：目的:比较数字化射线摄影(Digital Radiography,DR)和多层螺旋CT(Multislice Spiral Computed Tomography,MSCT)对肺内炎症肿块、2cm以下周围型肺癌(Peripheral lung cancer,PLC)的鉴别价值。方法:随机选取2020年3月~2023年7月本院放射科94例肺内炎症肿块或2cm以下PLC患者(经病理确诊)纳入研究,并进行DR和MSCT检查(两次检查时间间隔不得超过1周)。两位主治医师独立进行图像阅读和诊断,根据DR和MSCT的表现对炎症肿块和PLC进行鉴别。以手术病理检测结果为金标准,对比两种方案的鉴别价值。结果:94例患者中肺内炎性肿块患者65例、2cm以下PLC者29例。DR对肺内炎症肿块的鉴别敏感度、特异度分别为81.45%、75.86%,MSCT诊断分别为92.31%、75.86%,两组对比无差异(P>0.05)。DR、MSCT联合鉴别的精确度为96.81%(91/94),高于单独检测(P<0.05)。影像学形态可见,DR显示肺内炎症肿块多为不典型肿块、边缘模糊。MSCT平扫下肺内炎症肿块征象与DR相似,增强扫描下多为不显著增强。2cm以下PLC,MSCT、DR检测均显示为外侧边缘清晰、典型肿块,同时分叶征、毛刺、胸膜凹陷征的检出率高于肺内炎症肿块。MSCT增强扫描下,肺癌结节多为明显增强。肺内炎症肿块、2cm以下PLC在DR、MSCT两种检测方式下,征象存在明显差异(P<0.05)。DR、MSCT单独甄别和联合甄别的AUC为0.787(95%CI:0.690~0.865)、0.875(95%CI:0.791~0.934)和0.958(95%CI:0.895~0.988)。结论:DR、MSCT在肺内炎症肿块和2cm以下PLC的鉴别诊断中均具有一定价值,同时综合应用两种方法或可提高肺部疾病的诊断准确性,实现早期诊断与干预。Objective:To compare the value of digital radiography(DR)and multi-slice spiral CT(MSCT)in the identification of intrapulmonary inflammatory mass and peripheral lung cancer(PLC)below 2cm.Methods:Between March 2020 and July 2023,94 patients with pulmonary inflammatory masses or PLC less than 2cm(confirmed by pathology)were randomly selected in the radiology department of our hospital to be included in the study.The DR and MSCT examinations were performed(the interval between the two examinations should not exceed 1 week).Image reading and diagnosis were performed independently by two attending physicians,who differentiated the inflammatory mass from the PLC based on the manifestations of DR And MSCT.With the results of pathological examination as the gold standard,the differential value of the two schemes was compared.Results:Among the 94 patients,65 had pulmonary inflammatory mass and 29 had PLC below 2cm.The sensitivity and specificity of DR were 81.45%and 75.86%,respectively,and the MSCT were 92.31%and 75.86%,respectively.There was no difference between the two groups(P>0.05).The accuracy of the combined identification of DR and MSCT was 96.81%(91/94),which was higher than that of single detection(P<0.05).Imaging morphology showed that DR Showed that most of the inflammatory masses in the lung were atypical masses with blurred edges.The signs of pulmonary inflammatory mass under MSCT plain scan were similar to those under DR,but most of them were not significantly enhanced under enhanced scan.For the PLC below 2cm,MSCT and DR Tests below showed that the lateral edge was clear and typical.The detection rate of lobed sign,burr and pleural depression sign was higher than that of the pulmonary inflammatory mass.Under MSCT enhanced scan,most lung cancer nodules were significantly enhanced.The signs of pulmonary inflammatory mass and PLC below 2cm were significantly different between DR And MSCT detection methods(P<0.05).The AUC of DR And MSCT screening alone and in combination were 0.787(95%CI:0.690-0.865),0.875(95%

关 键 词：数字化射线摄影 多层螺旋CT 肺内炎症肿块 周围型肺癌 鉴别诊断 

分 类 号：R445[医药卫生—影像医学与核医学]