形态学特征评分联合能谱CT参数诊断孤立性肺结节的临床研究

Clinical Study on Morphological Feature Score Combined with Energy Spectrum CT Parameters in the Diagnosis of Solitary Pulmonary Nodules

目的研究形态学特征评分联合能谱CT参数对孤立性肺结节（SPN）的诊断价值。方法以我院2014年6月~2015年7月经病理结果证实的46例SPN患者为研究对象,根据病理结果将其分为恶性结节组与良性结节组,所有患者均接受能谱CT检查,经专业工作站分析图像并显示肺结节形态学特征,同时对病灶行能谱分析,有效结合其形态学特征及能谱参数,评价诊断敏感度、特异度及准确度。结果恶性结节组形态学特征主观评分、综合评分分别为（4.23±0.12）分、（4.14±0.21）分,分别显著高于良性结节组的（2.07±0.21）分、（2.41±0.22）分,差异有统计学意义（P〈0.001）。形态学特征评分结合能谱分析结果：方案一对SPN诊断敏感度、特异度、准确度分别为98.4%/91.7%/96.0%,方案二敏感度、特异度、准确度分别为96.9%、88.9%、94.0%,方案三敏感度、特异度、准确度分别为92.2%、80.6%、88.0%。结论形态学特征评分联合能谱CT参数诊断SPN有重要价值,敏感度、特异度及准确度均较高。

Objective To study the diagnostic value of morphological feature score combined with energy spectrum parameters CT in solitary pulmonary nodules（SPN）. Methods 46 patients with SPN confirmed by pathological findings in the hospital during February 2013 to May 2015 were treated as the research objects. According to the pathological findings, the patients were divided into the malignant nodule group and the benign nodule group. All patients underwent CT examination. The images were analyzed by professional workstation and the morphological features of pulmonary nodules were displayed. Meanwhile, the energy spectrum analysis was performed on the energy spectrum browser. The morphological features and energy spectrum parameters were effectively combined to evaluate the sensitivity, specificity and accuracy. Results The subjective score of morphological features and comprehensive score of the malignant nodule group were（4.23±0.12） and（4.14±0.21） points which were significantly higher than（2.07±0.21） and（2.41±0.22） points of the benign nodule group, respectively. The differences were statistically significant（P〈0.001）. The results of morphological feature score combined with energy spectrum analysis showed that the sensitivity, specificity and accuracy of scheme one in the diagnosis of APN were 98.4%, 91.7% and 96.0%, respectively while those of scheme two were 96.9%, 88.9% and 94.0%, respectively and of scheme three were 92.2%, 80.6% and 88.0% respectively. Conclusion Morphological feature score combined with energy spectrum CT parameters is of significant value in the diagnosis of APN and the sensitivity, specificity and accuracy are relatively high.