CT三维重建对孤立性肺结节与支气管关系的评价

Value of computed tomography three-dimensional reconstruction in evaluating the relationship between solitary pulmonary nodules and bronchi

目的探讨CT三维重建对孤立性肺结节(SPN)与支气管关系的价值。方法选择2015年3月至2017年3月期间在海南省人民医院经手术病理证实的67例恶性孤立性肺结节患者及30例良性孤立性肺结节患者为研究对象,所有患者均接受胸部螺旋CT检查,观察3D-CT与2D-CT图像对病灶诊断情况,探讨支气管-孤立性肺结节类型与病变性质的关系。结果在67例恶性孤立性肺结节中,3D-CT诊断符合率为94.0%,明显高于2D-CT图像的74.6%,差异具有统计学意义(P<0.05);恶性孤立性肺结节以Ⅰ型为主(52.2%),Ⅱ型次之(31.3%);良性孤立性肺结节以Ⅲ型为主(53.3%),Ⅳ型次之(30.0%);在各型支气管-孤立性肺结节类型中,良恶性孤立性肺结节所占比例比较差异具有统计学意义(P<0.05)。结论螺旋CT三维重建能够清晰显示孤立性肺结节与支气管关系,为定性诊断提供有价值的信息。

Objective To discuss the value of computed tomography （CT） three-dimensional reconstruction for evaluating the relationship between solitary pulmonary nodules （SPN） and bronchi. Methods Sixty-seven patients with malignant SPN who confirmed by pathology and 30 patients with benign SPN in Hainan General Hospital from March 2015 to March 2017 were selected as the research objects. All patients underwent chest spiral CT examination. The diag-nosis of the lesion by 3D-CT and 2D-CT images was observed. The relationship between the type of bronchial solitary pulmonary nodules and the nature of the lesions were investigated. Results Among the 67 cases of malignant SPN, the diagnostic coincidence rate of 3D-CT was significantly higher than that of 2D-CT （94.0%vs 74.6%）, P〈0.05. Malignant SPN were mainly typeⅠ（52.2%）, followed by typeⅡ（31.3%）. Benign SPN were mainly typeⅢ（53.3%）, followed by typeⅣ（30.0%）. Among the various types of bronchial SPN, the proportion of malignant and benign SPN showed statis-tically significant difference （P〈0.05）. Conclusion Spiral CT three-dimensional reconstruction can clearly show the re-lationship between SPN and bronchi, which provides valuable information for qualitative diagnosis.