CT影像学检查对孤立性肺结节良恶性的诊断价值分析  

Analysis of the Diagnostic Value of CT Imaging in Determining the Malignancy of Solitary Pulmonary Nodules

作　　者：张文伟 安楠 ZHANG Wenwei;AN Nan(Department of Imaging,The Third People's Hospital of Luoyang(Affiliated Hospital of Luoyang Vocational and Technical College),Luoyang Henan 471002,China)

机构地区：[1]洛阳市第三人民医院(洛阳职业技术学院第一附属医院)影像科,河南洛阳471002

出　　处：《临床研究》2025年第5期24-27,共4页Clinical Research

摘　　要：目的以提高孤立性肺结节(SPN)的良恶性鉴别诊断精准度为目标,探讨计算机断层扫描(CT)在该领域的实际应用价值。方法回顾分析洛阳市第三人民医院2022年10月至2024年10月收治的88例SPN病例资料作为研究样本。所有样本均经手术病理证实,同时全部样本均术前完成CT平扫+动态增强扫描,分析CT技术在SPN影像诊断领域的差异,统计诊断准确率、影像特征等资料。并以手术病理结果为金标准,分析良恶性SPN的CT诊断效能和CT值情况。结果病理诊断SPN恶性病变32例,良性病变56例,CT平扫诊断恶性病变44例,良性病变44例,CT动态增强扫描诊断恶性病变42例,良性病变46例。CT动态增强扫描影像学特征的检出恶性病变影像学特征中的磨玻璃征、棘突征、毛刺征、分叶征、胸膜凹陷、血管集束均高于良性病变,差异均有统计学意义(P<0.05)。临床诊断效能方面,CT平扫敏感度为65.62%,特异度为58.93%,阳性预测值为47.73%,阴性预测值为75.00%,准确度为61.36;CT动态增强扫描敏感度为90.62%,特异度为76.79%,阳性预测值为69.05%,阴性预测值为93.48%,准确度为81.82。CT平扫的上述诊断效能指标水平皆低于CT动态增强扫描,差异均有统计学意义(P<0.05)。SPN良、恶性病变的动态增强扫描CT值在不同时间点(0 s、30 s、90 s、180 s、240 s、360 s)的差异均有统计学意义(P<0.05)。结论CT动态增强扫描在SPN良、恶性病变的鉴别诊断中具有较高的灵敏度和特异度,能够准确地识别恶性结节,减少误诊和漏诊的发生。Objective To explore the practical application value of computed tomography(CT)in improving the accuracy of differential diagnosis between benign and malignant solitary pulmonary nodules(SPN).Methods A retrospective analysis was conducted on the data of 88 patients with SPN admitted to The Third People's Hospital of Luoyang from October 2022 to October 2024.All samples were confirmed by surgical pathology,and all underwent preoperative CT plain scan and dynamic contrast-enhanced scan.The differences in CT technology for SPN imaging diagnosis were analyzed,and the diagnostic accuracy and imaging features were statistically assessed.The surgical pathology results served as the gold standard to analyze the diagnostic efficacy of CT and CT values for benign and malignant SPN.Results Pathology revealed 32 cases of malignant lesions and 56 cases of benign lesions.The CT plain scan diagnosed 44 cases of malignant and 44 cases of benign lesions,while the dynamic contrast-enhanced scan diagnosed 42 cases of malignant and 46 cases of benign lesions.The detection rates of the imaging features of malignant lesions on CT dynamic contrast-enhanced scans,including ground-glass opacity,spiculated sign,burr sign,lobulation sign,pleural indentation,and vascular clustering,were all higher than those of benign lesions,showing statistically significant differences(P<0.05).In terms of clinical diagnostic efficacy,the sensitivity of the CT plain scan was 65.62%,specificity was 58.93%,positive predictive value was 47.73%,negative predictive value was 75.00%,and accuracy was 61.36%.The sensitivity of the dynamic contrast-enhanced scan was 90.62%,specificity was 76.79%,positive predictive value was 69.05%,negative predictive value was 93.48%,and accuracy was 81.82%.All diagnostic performance indicators for the CT plain scan were lower than those for the dynamic contrast-enhanced scan,with statistically significant differences(P<0.05).There were statistically significant differences in the CT values of benign and malignant SPN at different

关 键 词：CT 影像学 孤立性肺结节 良性 恶性 诊断效能 

分 类 号：R563[医药卫生—呼吸系统]