CT薄层影像学对肺小结节良恶性的诊断价值

Diagnostic Value of Thin-slice CT Imaging in Benign and Malignant Pulmonary Nodules

目的探讨CT薄层影像学对肺小结节良恶性的诊断价值。方法前瞻性分析我院肿瘤科2018年1月-12月接诊肺小结节患者120例CT薄层影像学诊断结果及病理检查结果。根据病理诊断结果将其分成良性组(84例)及恶性组(36例)。结果良性组84例患者中结核21例、炎性假瘤27例、错构瘤13例、肺脓肿10例、支气管囊肿12例。恶性组36例患者中腺癌14例、小细胞癌10例、鳞癌6例、转移癌4例及类癌2例。恶性组CT边缘、短毛刺、分叶征、血管集束征、胸膜凹陷征发生比高于上良性组(P<0.05),空洞、空泡征、钙化及空气支气管征比较结果无统计学意义(P>0.05)。敏感性前二位分别是边缘不光滑、分叶征;特异性前二位分别是胸膜凹陷征、血管集束征;准确性前二位分别是分叶征、胸膜凹陷征;阳性预测值前二位分别是分叶征、毛刺征。恶性组"1+2"个征象比高于良性组(P<0.05),"1+3"、"2+3"、"1+2+3"个征象比低于良性组(P<0.05)。结论 CT薄层影像学对肺小结节良恶性诊断有一定价值,恶性结节多3个征象,且图像清晰容易鉴别,可推广。

Objective To investigate the diagnostic value of thin-slice CT imaging in benign and malignant pulmonary nodules.Methods A prospective analysis was conducted on the thin-slice CT imaging diagnosis results and pathological examination results of 120 patients with pulmonary nodules admitted to the oncology department of our hospital between January and December,2018.Patients were divided into benign group(n=84)and malignant group(n=36)according to the pathological diagnosis.Results In the benign group,there were 21 cases of tuberculosis,27 cases of inflammatory pseudotumor,13 cases of hamartoma,10 cases of pulmonary abscess and 12 cases of bronchial cyst.In the malignant group,there were 14 cases of adenocarcinoma,10 cases of small cell carcinoma,6 cases of squamous cell carcinoma,4 cases of metastatic carcinoma and 2 cases of carcinoid.The incidence of CT margin,short burr,lobulated sign,vascular bundle sign and pleural indentation in the malignant group was higher than that in the benign group(P<0.05),while no significant difference was found in the incidence rate of cavity,vacuole sign,calcification and air bronchus(P>0.05).The first two sensitivities were non-smooth margin and lobulated sign,the first two specificities were pleural indentation sign and vascular cluster sign,the first two accuracy were lobulated sign and pleural indentation sign,and the first two positive predictive values were lobulated sign and burr sign.The ratio of "1+2" signs in malignant group was higher than that in benign group(P<0.05).The ratio of "1+3","2+3",and "1+2+3" signs in malignant group was lower than that in benign group(P<0.05).Conclusion Diagnostic value of thin-slice CT imaging in benign and malignant pulmonary nodules is significant,moreover,most of the malignant nodules are 3 signs,and the images are clear and easy to identify,which is worthy of promotion.