孤立性肺结节与胸膜关系的MSCT评价

MSCT Evaluation of the Relationship Between Solitary Pulmonary Nodule and Pleura

目的探讨孤立性肺结节与胸膜关系定量评价指标在良、恶性病变鉴别诊断中的价值。方法回顾分析2010年1月至2015年7月期间经病理证实的49例(良性组23例,恶性组26例)胸膜下孤立性肺结节的CT影像资料,分别测量胸膜径线和结节径线,然后计算胸膜径线与结节径线的比值R,比较上述指标在良性和恶性结节中的差异。结果良性组与恶性组的结节径线分别为(21.26±5.00)mm和(19.78±4.96mm)(t=1.041,P=0.303);胸膜径线分别为26.11 mm,13.4 8mm(Median,Q)和13.83 mm,5.86 mm(Median,Q),(Z=-4.968,P=0.000);比值R分别为1.25,0.25(Median,Q)和0.75,0.23(Median,Q),(Z=-5.489,P=0.000)。结论通过测量胸膜径线和R值可以为胸膜下孤立性肺结节的鉴别诊断提供更多信息。

Objective To explore the value of multi slice computed tomography in evaluating the relationship between solitary pulmonary nodule and pleura. Methods From Jan 2010 to Jul 2015,49 patients （35 men, 14 women; 22 - 80 y; 23 benign nodules, 26 malignant nodules） received a pathologic diagnosis and CT scan. The diameter of nodule and thickened pleura were measured, then the ratio of diameter between thickened pleura and nodule（ R value） were calculated and compared the difference between benign nodules and malignant nodules about these parameters. Results The diame- ter of benign nodules and malignant nodules were （21.26±5.00） mm and （ 19.78±4.96 ） mm respectively （ t = 1. 041, P =0. 303）, the diameter of thickened pleura were 26. llmm, 13.48mm（ Median, Q） and 13.83mm,5.86mm（ Median, Q） respectively （ Z = - 4. 968, P = 0. 000 ）, and R value were 1.25,0.25 （ Median, Q ） and 0.75,0.23 （ Median, Q ） respectively （ Z = - 5. 489,P = 0.000）. Conclusion Measuring the diameter of thickened pleura and R value may offer more infor- mation to differentiate benign and malignant solitary pulmonary nodule.