摘要
目的分析薄层多层螺旋CT(MSCT)重建在不同性质肺微小结节鉴别诊断中的效能。方法选取2021年3月至2024年3月就诊的204例疑似肺微小结节患者,均接受薄层MSCT检查。分析薄层MSCT对肺微小结节的检出率,并以病理结果为金标准,采用Kappa一致性检验,分析薄层MSCT诊断肺微小结节的效能。结果204例疑似肺微小结节患者共有236个结节,经病理检查确诊84个;薄层MSCT诊断肺微小结节,多平面重建(MPR)检出率、误诊率及漏诊率分别为39.41%、8.47%、4.66%;容积再现(VRT)检出率、误诊率及漏诊率分别为40.68%、8.90%、3.81%;联合检测检出率、误诊率及漏诊率分别为43.64%、9.75%、1.69%。薄层MSCT诊断肺微小结节,MPR、VRT及联合检测诊断敏感度分别为86.90%、89.29%、95.24%,特异度分别为86.84%、86.18%、84.87%,Kappa值分别为0.720、0.731、0.762。84个肺微小结节患者经金标准确诊良性肺微小结节46个,恶性38个,其中炎性结节28个、腺癌19个、鳞癌17个、错构瘤11个、良性肉芽肿7个、转移瘤2个;经薄层MSCT检测,MPR、VRT及联合检测诊断不同性质肺微小结节的符合率分别为73.81%、76.19%、82.14%,Kappa值分别为0.698、0.707、0.726。结论在肺微小结节的鉴别诊断中,采用薄层MSCT的多种重建方式可通过良恶性肺微小结节图像差异进行鉴别,显著提高鉴别诊断准确性。
Objective To analyze the efficacy of thin-slice multi-slice spiral CT(MSCT)reconstruction in the differential diagnosis of pulmonary micronodules of different natures.Methods A total of 204 patients with suspected pulmonary micronodules who visited the hospital from March 2021 to March 2024 were selected and all underwent thin-slice MSCT examination.The detection rate of thin-slice MSCT for pulmonary micronodules was analyzed,and taking the pathological results as the gold standard,the Kappa consistency test was used to analyze the efficacy of thin-slice MSCT in diagnosing pulmonary micronodules.Results Among the 204 patients with suspected pulmonary micronodules,there were a total of 236 nodules.Among them,84 were diagnosed by pathological examination,and thin-slice MSCT was used in diagnosing pulmonary micronodules.The detection rate,misdiagnosis rate and missed diagnosis rate of pulmonary micronodules diagnosed by multiplanar reconstruction(MPR)were 39.41%,8.47% and 4.66%,respectively.The detection rate,misdiagnosis rate and missed diagnosis rate of volume reproduction(VRT)were 40.68%,8.90% and 3.81%,respectively.The detection rate,misdiagnosis rate and missed diagnosis rate of the combined detection were 43.64%,9.75% and 1.69%,respectively.For the diagnosis of pulmonary micronodules by thin-slice MSCT,the diagnostic sensitivities of MPR,VRT detection alone and in combination were 86.90%,89.29% and 95.24%,respectively,the specificities were 86.84%,86.18%and 84.87%,respectively,and the Kappa values were 0.720,0.731 and 0.762,respectively.Among 84 patients with pulmonary micronodules,46 micronodules were diagnosed as benign and 38 as malignant by the gold standard,including 28 inflammatory nodules,19 adenocarcinomas,17 squamous cell carcinomas,11 hamartomas,7 benign granulomas,and 2 metastatic tumors.After thin-slice MSCT detection,the coincidence rates of MPR,VRT and detection alone and in combination in diagnosing pulmonary micronodules of different natures were 73.81%,76.19% and 82.14%,respectively,and the Kappa values were 0.698,0.707 and 0.726,respectively.Conclusion In the differential diagnosis of pulmonary micronodules,various reconstruction methods of thin-slice MSCT can be used for differentiation through the image differences of benign and malignant pulmonary micronodules,significantly improving the accuracy of differential diagnosis.
作者
庄庆丰
李小伟
ZHUANG Qingfeng;LI Xiaowei(Department of Imaging Center,the First Hospital of Qinhuangdao City,Qinhuangdao,Hebei 066000,China;Department of Cardiac Surgery,the First Hospital of Qinhuangdao City,Qinhuangdao,Hebei 066000,China)
出处
《临床误诊误治》
2025年第13期31-34,共4页
Clinical Misdiagnosis & Mistherapy
基金
河北省2024年度医学科学研究课题(20240780)
秦皇岛市科技计划自筹项目(201902A110)。
关键词
肺微小结节
薄层多层螺旋CT
重建方式
多平面重建
容积再现
诊断效能
ulmonary micronodules
Thin-slice multi-slice spiral CT
Reconstruction method
Multiplanar reconstruction
Volume reproduction
Diagnostic efficacy
