MSCT MinP成像在肺气肿诊断中的应用价值

Application of MSCT MinP Imaging in Diagnosing Pulmonary Emphysema

目的探讨MSCT最小密度投影(MinP)后处理技术在肺气肿诊断中的应用价值。方法搜集2013年4月至2014年9月在本院行胸部影像检查的710例患者的胸部X线平片和1.5 mm薄层CT资料。对全部病例的1.5 mm薄层CT图像行Min P重组,然后由两组医师行双盲法阅片,比较MinP重组后诊断率与X线平片及常规CT图像之间的差异。结果 710例中,X线平片诊断肺气肿99例,1.5 mm薄层CT诊断肺气肿134例,MinP重组诊断肺气肿325例。与MinP重组相比,X线平片假阳性27例,过诊率达7.0%(27/385),少诊253例,漏诊率达77.8%(253/325);1.5 mm薄层CT假阳性9例,过诊率达2.3%(9/385),少诊200例,漏诊率为61.5%(200/325)。结论 MinP后处理技术对肺气肿的显示率明显高于X线胸片和1.5 mm薄层CT,对肺气肿的早期诊断有价值。

Objective To evaluate the application of post-processing technique of minimum intensity projection （MinP） imaging in diagnosing pulmonary emphysema. Methods A total of T10 patients, who were encountered at authors＇ hospital and received chest radiography as well as thin-slice （1.5mm） CT scanning during the period from April 2013 to Sep. 2014, were enrolled in this study. MinP reformation of CT images was performed in all patients. Using double blind method, the images were separately reviewed by two groups of radiologists. The results were compared between radiography, thin-slice （1.5mm） CT scans and MinP reformation. Results Of the 710 patients, the diagnosis of pulmonary emphysema was made by radiography in 99, by thin-slice （1.5mm） CT scan in 134, and by MinP reformation in 325. Compared with MinP reformation, the false positive diagnosis judged by radiography was made in 27 cases, with the excessive diagnosis rate being up to 7.0% ; and the misdiagnosis judged by radiography was made in 253 cases, with the misdiagnosis rate being up to 77.8%. The false positive diagnosis judged by thin-slice （1.5mm） CT scan was made in 9 cases, with the excessive diagnosis rate being 2.3% ; and the misdiagnosis judged by thin-slice （1.5mm） CT scan was made in 200 cases, with the misdiagnosis rate being up to 61.5%. Conclusion For imaging diagnosis of pulmonary emphysema, the display rate of post-processing technique of minimum intensity projection imaging is strikingly higher than that of chest radiography and that of thin-slice （1.5mm） CT scan. Therefore, MinP reformation is of great value in making early diagnosis of pulmonary emphysema.