毛刺征在CT诊断周围型小肺癌中的价值

Value of Spiculation on CT in Diagnosis of Small Peripheral Lung Carcinoma

目的:探讨周围型小肺癌(SPLC)毛刺的CT表现、诊断价值及多平面重建(MPR)的检出作用。材料和方法:分析经手术或穿刺病理证实的135例SPLC及65例良性孤立性肺结节。统计CT边缘有毛刺征结节的例数,以宽度2mm为界将毛刺分为粗或细毛刺,以长度5mm为界分为长或短毛刺。对22例SPLC及15例良性结节进行MPR,并与横断薄层扫描对比分析。结果:细短毛刺明显多见于SPLC,敏感性为25.9%,特异性为98.5%,准确性为49.5%,阳性预测值(PPV)为97.2%。MPR对毛刺征的检出率高于横断薄层图像。结论:毛刺征对SPLC的诊断和鉴别诊断具有较高价值。

Purpose： To evaluate the CT manifestations, diagnosis value and multiplanar reconstruction （MPR） detection of spiculation in small peripheral lung carcinoma （SPLC）. Materials and Methods. One hundred and thirty-five cases with pathologically proved SPLC and 65 cases with benign nodules were collected. Counted the cases manifested spiculation on CT, divided the spiculation into thick or thin on the width of 2mm and long or short on 5mm. MPR was performed to compare with axial thin-slice images in 22 SPLC and 15 benign nodules. Results： Thin and short spiculation were seen much more often in SPLC, the sensitivity was 25.9% , the specificity was 98.5%, the accuracy was 49.5% and the positive predictive value （PPV） was 97.2%. The detection of spiculation by MPR was significantly higher than axial thin-slice images. Conclusion： Spiculation has the higher value in diagnosing and differentiating SPLC.