螺旋CT薄层扫描并MPVR重建对孤立性肺结节的诊断价值

The diagnostic value in solitary pulmonary nodules with thin slice spiral CT and MPVR reconstruction imaging

目的：探讨螺旋CT肺薄层扫描并多层面重建对孤立性肺结节的诊断价值。方法：对86例SPN患者进行螺旋CT规范化检查，并使用多层面重建（MPVR）技术重建观察。病灶结节直径选在0.8-3.0cm，病历均经临床手术或肺穿刺活检病理证实。其中恶性59例，均为原发性肺癌，包括腺癌25例、鳞癌17例、细支气管肺泡癌10例、小细胞未分化癌7例；良性病变27例，包括结核灶13例、炎性假瘤9例、错构瘤5例。结果：86例SPN的CT征象中，分叶征和棘突或毛刺征多出现于恶性结节，与病理和随访结果对比，螺旋CT薄层扫描并MPVR重建判断肺小结节良恶性的准确率、灵敏度、特异性、阳性预测值和阴性预测值分别为75.6%、76.3%、74.1%、86.5%、58.8%。结论：SCT肺薄层扫描并MPVR重建能显示更多的SPNCT征象，对SPN的良恶性诊断有较高的诊断价值。

Objective：To discuss the diagnostic value with thin slice spiral CT （ SCT ） imaging and multiplanar volumetric reformation （MPVR） in patients with solitary pulmonary nodules （SPN）. Methods：The thin slice SCT scanning and MPVR reconstruction imaging were obtained for 86 patients. The diameter of nodules was between 0.8cm and 3.0cm. They had been divided into malignant nodules （59 cases） and benign ones （27 cases）. 59 cases with lung cancer were studied, including 25 cases with adenocarcinoma, 17 cases with squamous carcinoma, 10 cases with bronehioloalveolar carcinoma, 7 cases with small cell cancer and 3 cases with metastasis carcinoma. 27 patients with benign pulmonary nodules were investigated, including 13 cases with tuberculosis （ TB ） lesion, 9 cases with inflammatory pseudotumor, 5 cases with hamartoma, All aforementioned cases enfierely were proved patholngieal diagnosis using operation or lung centesis, Results：On the CT manifestation, lobulation sign and spiculation sign mostly appeared in the malignant nodules. The accurate rate of diagnosis was 75.6; sensitivity were 76.3 % ; specificity .were 74.1% ; positive predictive value （PPV） were 86.5 % ; negative predictive value （NPV） were 58.8%. Conclusion： The thin slice SCT and MPVR reconstruction can show more sign of SPN, and it has great value in differentiation SPN diagnosis.