多层螺旋CT灌注成像参数在肺内磨玻璃样结节中的诊断价值研究

Rearch of diagnostic value of CT perfusion imaging parameter in pulmonary ground-glass nodules

目的:探讨多层螺旋CT灌注成像参数在肺内磨玻璃样结节(GGN)中的诊断价值。方法:选取2012年1月至2015年6月,在我院经过手术或者穿刺活检证实的GGN患者128例,采用多层螺旋CT灌注成像参数对GGN良、恶性病变进行诊断,比较CT灌注参数血容量(BV)、渗透性表面积容积(PS)对于鉴别肺内良、恶性结节的诊断价值,通过绘制ROC曲线比较BV、PS对GNN的诊断效能。结果:恶性病变BV、PS均高于良性病变(t值分别为9.63,26.27,P值分别为0.022,0000);绘制ROC曲线分析发现,BV的诊断临界值在7.65 m L/100g,以此为阈值时发现,其灵敏度、特异性、阳性预测值、阴性预测值以及诊断准确率分别为92.41%、76.37%、85.25%、72.36%及86.91%;PS的诊断临界值在17.90 m L·min^(-1)·100g^(-1),以此为阈值时发现,其灵敏度、特异性、阳性预测值、阴性预测值以及诊断准确率分别为93.15%、82.56%、89.81%、82.55%及91.19%;BV与PS两者联合时,灵敏度、特异性、阳性预测值、阴性预测值以及诊断准确率分别为95.34%、86.74%、93.22%、86.76%及93.82%。结论:多层螺旋CT灌注成像技术在GGN良、恶性病变中具有一定的诊断价值,值得进一步研究。

Objective： To evaluate the diagnostic value of CT perfusion imaging parameter in the palmonary ground-glass nodule （GGN）. Methods： 128 cases of GGN patients after surgery or biopsy confirmed were selected in our hospital from January 2012 to June 2015, multi-slice spiral CT perfusion imaging was used for the diagnosis of GGN benign and malignant lesions, and compared the diagnostic value of blood volume （BV）, permeability surface area volume （PS） in differentiating pulmonary benign and malignant nodules and compared BV, PS diagnostic efficacy of GNN by plotting ROC curve. Results： BV, PS in malignant lesions were higher than benign lesions （ t values were 9. 63, 26. 27, P values were 0. 022, 0. 000）. ROC curve ＆awed to analysis, BV at diagnostic threshold was 7. 65 mL/100g, as its threshold value then we found that the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy rates of BV were 92. 41%, 76. 37%, 85.25%, 72. 36% and 86. 91%. PS at diagnostic threshold was 17.90 ml/min- 100g, as its threshold was found that the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy rates of PS were 93.15%, 82. 56%, 89. 81%, 82. 55% and 91.19%. BV combined with PS,the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy rates were 95. 34%, 86. 74%, 93.22%, 86. 76% and 93.82%. Conclusion： CT perfusion imaging had some diagnostic value in GGN benign and malignant lesions, it is worth further study.