摘要
目的优化和标准化多层螺旋CT(MSCT)肺灌注成像技术参数,并评价该方案的有效性及稳定性。方法收集肺内单发结节患者16例行MSCT肺灌注成像预实验,根据预实验结果与文献回顾初步确定灌注扫描方案。再扩大样本按已优化与标准化的参数对65例肺内单发结节患者进行MSCT肺灌注成像,分析影响灌注图像质量的主要因素,用ROC曲线、诊断效能参数与优势比(OR值)来评价该方案的有效性,用一致性分析来评价该方案的稳定性。结果65例患者中47例灌注图像满意并有病理证实,9例未明确病理诊断,9例图像质量不能满足灌注测量及计算的要求,呼吸不配合是导致灌注失败的主要原因,灌注成像诊断肺部单发结节性病变总的敏感度、特异度、准确性、阳性似然比、阴性似然比及ROC曲线下面积分别为76.9%、83.3%、82%、4.620、0.280、0.840,一致性为0.894,对比常规平扫增强,灌注成像诊断效能显著提高(χ2=4.27,P=0.031,OR=4.33)。结论优化与标准化后的MSCT肺灌注成像技术能显著提高诊断效能,稳定性好,值得推广。
Objective To optimize and standardize the technical parameter of multi-slice spiral CT pulmonary perfusion imaging, then to evaluate the effectiveness and stability of this scan protocol. Methods First, to determine the scan protocol according to the results of preliminary experiment and literature review, then based on the previous study, we studied in a larger sample size. We scanned 65 cases of lung single nodule ac- cording to the scan protocol of multi-slice spiral CT pulmonary perfusion imaging, then analyzed the main factors concerning the imaging quality, evaluated the effectiveness of scan protocol by determining the ROC curve, diagnostic efficacy and odds ratio, as well as the stability of scan protocol by consistency analysis. Results Forty-seven cases showed optimal images, resulting in correct diagnosis proved pathologically. Nine cases were made indefinite diagnosis. Nine cases were not up to the image quality for definite diagnosis mainly because of the patients＇ incompliant respiration. The total sensitivity, specificity, accuracy, likelihood ratio and the area under ROC curve for scan protocol were 76.9% , 83.3% , 82% , 4. 620, 0. 280, 0. 840 respectively and Kappa value was 0. 894. The diagnostic efficacy of multi-slice spiral CT pulmonary perfusion was significantly higher than that by CT plain and enhanced scan. Conclusion The optimized and standardized scan protocol of multi-slice spiral CT pulmonary perfusion imaging is effective in pathologic diagnosis and of well stability, worth being popularized.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2008年第20期1893-1896,共4页
Journal of Third Military Medical University
基金
湖南省科技厅自然科学基金(07JJ5010)~~
关键词
体层摄影术
x线计算机
灌注成像
优化设计
标准化
因素分析
统计学
tomography, X-ray computed
perfusion imaging
optimal design
standardization
factor analysis, statistical
