双源CT的Lung Care评估孤立性肺结节的应用价值研究

Application Research of Lung Care Software of Dual-source CT in Solitary Pulmonary Nodules

目的:探讨Siemens双源CT的Lung Care软件对孤立性肺结节的辅助诊断能力及适用范围。方法:收集双源CT扫描并经病理证实的肺内孤立性结节40例。应用Lung Care软件中的r-MPR或VOI法三维重建技术对SPN的基本征象进行分析,并与胸部CT常规扫描进行比较;其中20例肺结节患者于12个月内分3个阶段进行随访,以测量结节生长速度或倍增时间。结果:在40例SPN中,恶性结节28例,良性结节12例。胸部CT常规扫描与Lung Care软件三维重建对恶性结节诊断准确率分别为53.57%、82.14%,对良性结节诊断准确率分别为41.67%、83.33%,两者均有显著性差异(P<0.05)。Lung Care软件具有的自动分析测量结节体积功能,可准确地计算出结节体积、X径、Y径、Z径、最大径、最小径,通过20例12个月内随访,8例结节体积增大,7例结节体积缩小,5例结节体积不变,8例体积增大的结节中5例手术切除,经病理证实均为恶性结节。结论:Lung Care软件对肺结节的诊断具有一定辅助作用,可以有效地鉴别结节真伪,观察结节的形态特征,适应于对肺结节的良恶性鉴别诊断。

Objective To evaluate the auxiliary diagnostic ability and applicability of the Lung Care software of dualsource CT in the study of solitary pulmonary nodule（SPN）. Method8 40 cases with SPN proved by pathologically were examined by dual-source CT. R-MPR and VOI of Lung Care software three-dimension rebuilding image were obtained to analyze imaging features of SPN and compared with routine chest CT. 20 cases had regular visits during 12 months which were divided into three stages to measure the growing speed or doubling time. Results There were 28 cases of malignant nodules and 12 cases of benign nodules in 40 cases of SPN. The accuracy for malignancy of routine chest CT and LungCare software three-dimension rebuilding are 53.57%, 82.14% respectively. The accuracy for benign nodules is 41.67%, 83.33% respectively. Both are significant difference （P〈0.05）. There is remarkable difference between routine chest CT and Lung Care software three-dimension rebuild. The LungCare software has the function that automatically analyzes SPN and calculates out SPN volume, x-axis, y-axis, z-axis, max diameter, min diameter. Through 20 cases by regular visits found that SPN volume to increase in 8 cases, SPN volume to shrink in 7 cases, SPN volume no to change in 5 cases, 5 in 8 cases that volume increasing was operated and verified malignant tubercle by pathology. Conclusion The LungCare software has certain auxiliary function on the diagnosis of SPN by distinguishing the lung tubercle effectively and obseving the character of SPN form, which is useful to diagnose SPN benign or malignancy. [Chinese Modical Equipment Journal, 2009,30 （9） ： 70-72]