医学研究杂志
醫學研究雜誌
의학연구잡지
Journal of Medical Research
2015年
10期
76-79
,共4页
徐开武%姜刚录%吴江兴%冯贵华%陈东明
徐開武%薑剛錄%吳江興%馮貴華%陳東明
서개무%강강록%오강흥%풍귀화%진동명
孤立性肺结节%灌注成像%体层摄影术%X线计算机
孤立性肺結節%灌註成像%體層攝影術%X線計算機
고립성폐결절%관주성상%체층섭영술%X선계산궤
Solitary pulmonary nodules%Perfusion%Tomography%X-ray computed
目的 探讨多层螺旋CT灌注扫描对孤立性肺结节( SPN)的诊断价值,从而加强SPN良恶性的鉴别区分,提高定性诊断水平. 方法 选取笔者收集的经病理证实的SPN患者160例作为研究对象,对其临床资料进行回顾性分析. 采用常规16排螺旋CT机对患者行灌注扫描,应用GE ADW 4.3工作站的后处理技术及Perfusion3-body tumor软件对结节进行分析,对所获得的SPN的CT灌注的血流量( BF)、血容量( BV)、平均通过时间( MTT)及表面通透性( PS)等参数进行统计分析,并分析不同检查方法对诊断SPN的效能是否存在差异. 结果 恶性SPN和炎性SPN的BF、BV和PS值均明显高于良性SPN,良性组与恶性组SPN的BV(P=0.000)、BF(P=0.000)及PS(P=0.000)差异有统计学意义;良性组与炎性组SPN的BV(P=0.027)、BF(P=0.000)及PS(P=0.001)差异有统计学意义,恶性与炎性SPN各项灌注参数差异均无统计学意义(P>0.05). 以BV≥5ml/100g为恶性SPN诊断阈值,其敏感度、特异性、阳性预测值、阴性预测值分别为86.4%、72.2%、79.2%、81.3%. 设PS≥15ml/(min· 100g)为诊断恶性阈值,其敏感度、特异性、阳性预测值、阴性预测值分别为90.9%、66.7%、80.0%、85.7%. 设BV≥5ml/100g且PS≥15ml/( min· 100g)为诊断恶性阈值,其敏感度、特异性、阳性预测值、阴性预测值分别为95.5%、72.2%、80.8%、92.9%.结论 CT灌注成像对良恶性SPN的鉴别具有较高诊断价值,但对良恶性的鉴别缺乏特异性. 设定BV≥5ml/100g且PS≥15ml/(min· 100g)为诊断恶性阈值时,其诊断恶性SPN的敏感度、特异性及阳性预测值均高于设定单个参数的诊断效能.
目的 探討多層螺鏇CT灌註掃描對孤立性肺結節( SPN)的診斷價值,從而加彊SPN良噁性的鑒彆區分,提高定性診斷水平. 方法 選取筆者收集的經病理證實的SPN患者160例作為研究對象,對其臨床資料進行迴顧性分析. 採用常規16排螺鏇CT機對患者行灌註掃描,應用GE ADW 4.3工作站的後處理技術及Perfusion3-body tumor軟件對結節進行分析,對所穫得的SPN的CT灌註的血流量( BF)、血容量( BV)、平均通過時間( MTT)及錶麵通透性( PS)等參數進行統計分析,併分析不同檢查方法對診斷SPN的效能是否存在差異. 結果 噁性SPN和炎性SPN的BF、BV和PS值均明顯高于良性SPN,良性組與噁性組SPN的BV(P=0.000)、BF(P=0.000)及PS(P=0.000)差異有統計學意義;良性組與炎性組SPN的BV(P=0.027)、BF(P=0.000)及PS(P=0.001)差異有統計學意義,噁性與炎性SPN各項灌註參數差異均無統計學意義(P>0.05). 以BV≥5ml/100g為噁性SPN診斷閾值,其敏感度、特異性、暘性預測值、陰性預測值分彆為86.4%、72.2%、79.2%、81.3%. 設PS≥15ml/(min· 100g)為診斷噁性閾值,其敏感度、特異性、暘性預測值、陰性預測值分彆為90.9%、66.7%、80.0%、85.7%. 設BV≥5ml/100g且PS≥15ml/( min· 100g)為診斷噁性閾值,其敏感度、特異性、暘性預測值、陰性預測值分彆為95.5%、72.2%、80.8%、92.9%.結論 CT灌註成像對良噁性SPN的鑒彆具有較高診斷價值,但對良噁性的鑒彆缺乏特異性. 設定BV≥5ml/100g且PS≥15ml/(min· 100g)為診斷噁性閾值時,其診斷噁性SPN的敏感度、特異性及暘性預測值均高于設定單箇參數的診斷效能.
목적 탐토다층라선CT관주소묘대고립성폐결절( SPN)적진단개치,종이가강SPN량악성적감별구분,제고정성진단수평. 방법 선취필자수집적경병리증실적SPN환자160례작위연구대상,대기림상자료진행회고성분석. 채용상규16배라선CT궤대환자행관주소묘,응용GE ADW 4.3공작참적후처리기술급Perfusion3-body tumor연건대결절진행분석,대소획득적SPN적CT관주적혈류량( BF)、혈용량( BV)、평균통과시간( MTT)급표면통투성( PS)등삼수진행통계분석,병분석불동검사방법대진단SPN적효능시부존재차이. 결과 악성SPN화염성SPN적BF、BV화PS치균명현고우량성SPN,량성조여악성조SPN적BV(P=0.000)、BF(P=0.000)급PS(P=0.000)차이유통계학의의;량성조여염성조SPN적BV(P=0.027)、BF(P=0.000)급PS(P=0.001)차이유통계학의의,악성여염성SPN각항관주삼수차이균무통계학의의(P>0.05). 이BV≥5ml/100g위악성SPN진단역치,기민감도、특이성、양성예측치、음성예측치분별위86.4%、72.2%、79.2%、81.3%. 설PS≥15ml/(min· 100g)위진단악성역치,기민감도、특이성、양성예측치、음성예측치분별위90.9%、66.7%、80.0%、85.7%. 설BV≥5ml/100g차PS≥15ml/( min· 100g)위진단악성역치,기민감도、특이성、양성예측치、음성예측치분별위95.5%、72.2%、80.8%、92.9%.결론 CT관주성상대량악성SPN적감별구유교고진단개치,단대량악성적감별결핍특이성. 설정BV≥5ml/100g차PS≥15ml/(min· 100g)위진단악성역치시,기진단악성SPN적민감도、특이성급양성예측치균고우설정단개삼수적진단효능.
Objective To investigate the diagnostic value of multi -slice spiral CT perfusion scanning for SPN , and to strengthen the SPN differential diagnosis of benign and malignant distinguish , then to improve the diagnosis level .Methods One hundred and sixty cases of SPN patients were involved as the research object , and the clinical data were retrospectively analyzed .The 16 row spiral CT for patients underwent plain +dynamic enhanced scan +perfusion scan.The blood flow in nodules was analyze ,using GE ADW 4.3 work-station for post -processing technology and Perfusion 3 -body tumor software .CT perfusion on acquired SPN′s ( BF ) , blood volume (BV), the mean through time (MTT)and permeability surface (PS) were analyzed, and whether there were differences between the ef-fectiveness of different examination methods for the diagnosis of SPN was analyzed .Results BF, BV and PS values in Malignant nodules and inflammatory nodules were significantly higher than that of benign nodules .BV (P=0.000), BF (P=0.000) and PS (P=0.000) between the benign group and the malignant group had statistical significance .BV (P=0.027), BF (P=0.000) and PS (P=0.001) between the benign and inflammatory group had statistical significance .There was no significant difference between malignant nodules and inflammatory nodules perfusion value (P>0.05).With BV≥5ml/100g for diagnosis of malignant SPN threshold , the sensitivity, speci-ficity, positive predictive value, and negative predictive values were 87.5% (21/24), 72.2% (13/18), 80.7% (21/26), 81.3%(13/16).PS =15ml/(min· 100g) for the diagnosis of malignant threshold , the sensitivity, specificity, positive predictive value, and negative predictive values were 91.8%(22/24), 66.7%(12/18), 78.6%(22/29), 85.7%(12/14).BV was more than or equal to 5ml/100g and PS =15ml/(min· 100g) for the diagnosis of malignant threshold, the sensitivity, specificity, positive predictive value, and negative predictive values were 95.8%(23/24), 83.3% (15/18), 88.5% (23/26), 93.8% (15/16).Conclusion It is of high value in differentiating CT perfusion imaging of benign and malignant SPN , with BV greater than 5ml/100g and PS =15ml/(min· 100g) for the diagnosis of malignant threshold .The positive predictive value of SPN for diagnosis of malignant in 88.5%, but the differen-tial diagnosis of malignant and inflammatory SPN lackes of specificity .
