多层螺旋CT征象对孤立性肺结节病理性质的诊断价值  

Diagnostic value of MSCT signs for the pathological properties of solitary pulmonary nodules

作　　者：李波 王培培 阎晓宇 Li Bo;Wang Peipei;Yan Xiaoyu(Department of Medical Imaging,Pingdingshan Medical District,989 Hospital of PLA Joint Logistic Support Force,Henan 467000,China)

机构地区：[1]解放军联勤保障部队第九八九医院平顶山医疗区医学影像科,467000

出　　处：《实用医学影像杂志》2025年第2期129-134,共6页Journal of Practical Medical Imaging

摘　　要：目的探讨多层螺旋CT(MSCT)征象对孤立性肺结节(SPN)病理性质的诊断价值。方法采取回顾性研究,收集2022年2月至2024年2月医院收治的107例SPN患者的临床资料。所有患者经病理学检查结果分为良性组44例(41.1%)、恶性组63例(58.9%)。所有患者均在治疗前接受MSCT检查,对比2组MSCT征象;采用二元Logistic回归分析SPN患者MSCT征象与SPN病理性质的关系;绘制受试者工作特征(ROC)曲线分析MSCT征象对SPN病理性质的诊断价值。结果恶性组有分叶征、短毛刺征、胸膜凹陷征、血管集束征、空泡征患者的占比高于良性组,恶性组钙化患者占比低于良性组,恶性组结节直径大于良性组(P<0.05);经二元Logistic回归分析显示,分叶征、短毛刺征、胸膜凹陷征、血管集束征、结节直径是恶性SPN的危险因素(OR值>1,P<0.05),钙化是恶性SPN的保护因素(OR值<1,P<0.05);ROC曲线结果显示,MSCT征象联合诊断SPN患者SPN病理性质的AUC(95%CI)为0.912(0.860,0.963),P<0.05,特异度、灵敏度、约登指数分别为0.955、0.714、0.669。结论分叶征、短毛刺征、胸膜凹陷征、钙化、血管集束征、结节直径是鉴别SPN病理性质的重要MSCT征象,联合检测具有较高的诊断价值。Objective To investigate the diagnostic value of multi-slice spiral CT(MSCT)signs in patients with solitary pulmonary nodules(SPN)on the pathological properties.Methods A retrospective study was conducted to collect the clinical data of 107 patients with SPN admitted to the hospital from February 2022 to February 2024.All patients were divided into a benign group of 44 cases(41.1%)and a malignant group of 63 cases(58.9%)based on pathological examination results.All patients underwent MSCT examination before treatment,and the MSCT signs of the two groups were compared.Binary Logistic regression was used to analyze the relationship between MSCT signs and pathological properties of SPN in SPN patients.The receiver operating characteristic(ROC)curves were drawn to analyze the diagnostic value of MSCT signs for benign and malignant SPN.Results The proportion of malignant patients with lobulation signs,short hair prick signs,pleural depression signs,vascular bundle signs,and vacuolar signs was higher than that of the benign group,the proportion of calcified patients in the malignant group was lower than that in the benign group,and the diameter of nodules in the malignant group was larger than that in the benign group(P<0.05).Binary Logistic regression analysis showed that lobulation sign,short burr sign,pleural indentation sign,vascular convergence sign,and nodule diameter were risk factors for malignant SPN(OR>1,P<0.05),and calcification was a protective factor for malignant SPN(OR<1,P<0.05).The ROC curve results showed that the area under the curve(AUC)(95%CI)of MSCT signs combined with the pathological nature of SPN in patients with SPN was 0.912(0.860,0.963,P<0.05),which had a certain predictive value.The specificity,sensitivity,and Youden index were 0.955,0.714 and 0.669,respectively.Conclusion Lobulation sign,short burr sign,pleural indentation sign,calcification,vascular convergence sign,and nodule diameter are important MSCT signs to identify the pathological nature of SPN,and combined detection has high diagn

关 键 词：孤立性肺结节 多探头的计算机断层扫描 病理性质 诊断 

分 类 号：R563[医药卫生—呼吸系统]