计算机辅助孤立性肺结节的良、恶性鉴别诊断

Differential Diagnosis of Benign and Malignant Solitary Pulmonary Nodule with Computer-aided Detection

目的探讨良、恶性孤立性肺结节(SPN)增强后的形态学特征,为SPN的影像诊断提供依据。方法采用SPN图像处理专用软件,对23例恶性肿瘤患者和22例良性结节患者的增强前后CT扫描图像进行了分析比较。结果良、恶性结节组的强化与非强化比较结果显示差异有显著性(P<0.0001);良、恶性组的不规则强化比较结果显示差异有显著性(P=0.0084);恶性结节组的强化幅度平均为(45.04±26.76)HU,明显高于良性结节组的(15.70±17.84)HU(P=0.033);恶性结节组的最大强化CT值平均为(136.09±41.72)HU,明显高于良性结节组的(60.60±60.27)HU(P=0.007);恶性结节组的强化面积平均为(21.69±21.01)%,良性结节组的强化面积平均为(8.61±10.83)%,两组相比差异无显著性(P=0.203)。结论增强扫描后的强化幅度和最大强化值,以及在形态学上的不规则强化,可作为SPN临床影像诊断的参考依据。

Objective To investigate the morphological features of benign and malignant solitary pulmonary nodules （SPNs） and explore the radiological evidences for the differentiation of SPNs. Methods With SPN Dicom View software, we analyzed and compared images obtained from 23 patients with malignant SPNs and 22 patients with benign SPNs who received CT scanning with or without contrast medium injection. Results The enhancement in malignant SPNs group was significantly higher than in the benign SPNs group （ P 〈 0. 0001 ）. The irregular enhancement in malignant SPNs group was significantly higher than in the benign SPNs group （P = 0. 0084 ）. The mean range of enhancement was （45.04 ± 26. 76） HU in malignant SPNs group, which was significantly higher than that in the benign SPNs group [ （ 15.70 ± 17.84） HU, P = 0. 033 ]. The mean peak enhancement value was （136. 09 ± 41.72 ） HU in malignant SPNs group, which was significantly higher than in benign SPNs group [ （60. 60 ± 60. 27 ） HU, P = 0. 007 ]. The mean enhancement area was （21.69 ± 21.01 ）% in malignant SPNs group and （ 8.61 ± 10. 83 ） % in benign SPNs group （ P = 0. 203 ）. Conclusion The enhancement range and peak enhancement value as well as the morphologically irregular enhancement of SPNs may provide useful information in the clinical radiological diagnosis of SPNs.