摘要
目的分析在肺占位性病变诊断中应用64排螺旋CT三维重建的临床价值。方法纳入2020年1月至2022年12月在我院64排螺旋CT常规扫描筛查出的60例肺占位病变患者作为研究对象,所有患者均通过64排螺旋CT常规扫描和三维重建进一步诊断,以病理结果为金标准,对64排螺旋CT常规扫描和三维重建评估肺占位性病变性质的效能进行分析,同时比较不同性质肺占位性病变的64排螺旋CT三维重建图像特点。结果64排螺旋CT常规扫描的Kappa值为0.292,64排螺旋CT三维重建的Kappa值为0.822,可见64排螺旋CT三维重建与手术病理学检查诊断一致性高于64排螺旋CT常规扫描。经对比,64排螺旋CT三维重建评估肺占位性病变性质的准确率、灵敏度和特异度高于64排螺旋CT常规扫描(P<0.05);而误诊率和漏诊率均低于64排螺旋CT常规扫描(P<0.05)。良恶性肺占位性病变的内部结构和边界比较差异具有统计学意义(P<0.05),其中,良性肺占位病变的内部结构以纯磨玻璃结节为主,边界清晰,而恶性肺占位病变的内部结构以混合密度结节为主,边界模糊。同时,恶性肺占位病变的毛刺征、分叶征、小气道改变、胸膜凹陷征和血管纠集征等图像特点的占比高于良性肺占位病变(P<0.05)。结论 64排螺旋CT三维重建在肺占位性病变诊断中的应用价值良好,可为病变定性评估提供有效依据。
Objective To analyze the clinical value of applying 64-row spiral CT three-dimensional reconstruction in the diagnosis of lung occupying lesions.Methods Sixty patients with pulmonary space-occupying lesions screened by 64-row spiral CT routine scanning in our hospital from January 2020 to December 2022 were included as study subjects,all of whom were further diagnosed by 64-row spiral CT routine scanning and three-dimensional reconstruction,and the efficacy of 64-row spiral CT routine scanning and three-dimensional reconstruction in evaluating the nature of pulmonary space-occupying lesions were analyzed with the use of puncture biopsy as the gold standard,and at the same time the characteristics of 64-row spiral CT three-dimensional reconstruction images of different nature of lung occupying lesions were compared.Results The Kappa value of 64-row spiral CT conventional scan was 0.292,and the Kappa value of 64-row spiral CT three-dimensional reconstruction was 0.822,which showed that the diagnostic consistency between 64-row spiral CT three-dimensional reconstruction and surgical pathologic examination was higher than that of 64-row spiral CT conventional scanning.Upon comparison,the accuracy,sensitivity and specificity of 64-row spiral CT three-dimensional reconstruction for assessing the nature of lung-occupying lesions were higher than that of 64-row spiral CT conventional scanning(P<0.05).The misdiagnosis rate and the leakage rate for assessing the nature of lung-occupying lesions by 64-row spiral CT three-dimensional reconstruction were lower than that of 64-row spiral CT conventional scanning(P<0.05).The difference between the internal structures and boundaries of benign and malignant lung space-occupying lesions was statistically significant(P<0.05),in which the internal structures of benign lung space-occupying lesions were dominated by pure ground-glass nodules with clear boundaries,while the internal structures of malignant lung space-occupying lesions were dominated by mixed-density nodules with blurred boundaries.Meanwhile,the percentage of image features such as burr sign,lobulation sign,small airway changes,pleural depression sign and vascular entanglement sign were higher in malignant lung occupying lesions than in benign lung occupying lesions(P<0.05).Conclusion The application value of 64-row spiral CT three-dimensional reconstruction in the diagnosis of lung occupying lesions is good,and it can provide an effective basis for the qualitative assessment of lesions.
作者
刘勇玲
王红梅
Liu Yongling;Wang Hongmei(CT Room,the Second People′s Hospital of Jiaozuo,Jiaozuo 454000,China)
出处
《实用医技杂志》
2024年第5期339-342,共4页
Journal of Practical Medical Techniques
关键词
体层摄影术
螺旋计算机
平扫
三维重建
肺占位性病变
诊断
Tomography,spiral computed
Plan scan
Three-dimensional reconstruction
Lung space-occupying lesions
Diagnosis
