CAJ | 학술논문

目的：探讨肺内孤立结节（ SPN）高分辨CT征象对于良恶性的鉴别诊断价值。方法：回顾性分析经病理学确诊的129例SPN（恶性结节88例，良性结节41例）的高分辨CT征象，对不同征象在良恶性SPN中的发生率进行比较，评价不同指标的诊断敏感度、特异度及准确率。结果：恶性SPN的CT征象中前3位依次为毛刺征、分叶征和血管集束征，均高于在良性SPN中的发生率（χ2＝26．590、33．661和5．125，P均＜0．05）。当选择毛刺征、分叶征和血管集束征3种征象中的任意3个联合进行良恶性鉴别诊断时，毛刺征和分叶征联合指标的鉴别诊断敏感度、特异度和准确率分别为1．00、0．76和0．92，均高于单一CT征象鉴别诊断效能，3种征象联合鉴别诊断的敏感度未变，而特异度、准确率均下降。结论：高分辨CT能够清晰显示SPN的形态特征，毛刺征联合分叶征能够提高对SPN良恶性鉴别诊断的敏感度、特异度和准确率。
목적：탐토폐내고립결절（ SPN）고분변CT정상대우량악성적감별진단개치。방법：회고성분석경병이학학진적129례SPN（악성결절88례，량성결절41례）적고분변CT정상，대불동정상재량악성SPN중적발생솔진행비교，평개불동지표적진단민감도、특이도급준학솔。결과：악성SPN적CT정상중전3위의차위모자정、분협정화혈관집속정，균고우재량성SPN중적발생솔（χ2＝26．590、33．661화5．125，P균＜0．05）。당선택모자정、분협정화혈관집속정3충정상중적임의3개연합진행량악성감별진단시，모자정화분협정연합지표적감별진단민감도、특이도화준학솔분별위1．00、0．76화0．92，균고우단일CT정상감별진단효능，3충정상연합감별진단적민감도미변，이특이도、준학솔균하강。결론：고분변CT능구청석현시SPN적형태특정，모자정연합분협정능구제고대SPN량악성감별진단적민감도、특이도화준학솔。
Aim:To discuss high-resolution CT features of solitary pulmonary nodule ( SPN) in the differential diagno-sis of benign and malignant SPN .Methods:High-resolution CT features of 129 cases of pathologically confirmed SPN ( 88 cases of malignant SPN and 41 cases of benign SPN ) were retrospectively analyzed .Frequencies of different signs in benign and malignant SPN were compared .Results:The most frequent four CT signs of malignant SPN were spicule sign , lobula-tion, and vascular convergence , which were higher than their frequencies in benign SPN (χ2 =26.590,33.661,5.125,P<0.05).When combining any two of spicule sign , lobulation, and vascular convergence as indicator to diagnose benign and malignant SPN , the diagnostic sensitivity , specificity , and accuracy of spicule sign plus lobulation as a combined indicator were 1.00, 0.76, and 0.92, respectively, which were higher than those of single CT sign .Combining all these three signs for diagnosis didn′t affect sensitivity , but showed decreased specificity and accuracy .Conclusion: High-resolution CT could clearly show morphological characteristics of SPN .Combined use of spicule sign and lobulation could increase sensi-tivity, specificity, and accuracy of the differential diagnosis between benign and malignant SPN .