CT联合DR对早期周围型肺癌的诊断价值

The Diagnosis Value of CT Combined with Digital Radiography for the Early Peripheral Lung Cancer

目的:分析数字X线摄片(DR)、CT及其联合应用对周围型肺癌的诊断价值。方法:选择该院2012年2月~2016年3月收治早期周围型肺癌患者90例为研究对象,分别进行数字化X线摄影和CT检查,以手术切除或病理结果为最终诊断的金标准,计算两种检查方法及其联合对早期诊断周围型肺癌的敏感度、特异度和准确率阳性预测值以及阴性预测值。结果:胸部DR检出空泡征者7例(7.8%),分叶征47例(52.2%),边缘有细小毛刺征36例(40%),胸膜凹陷征9例(10%);CT见病变边缘分叶征71例(78.8%),长短毛刺征57例(63.3%),空洞征27例(30%),胸膜凹陷征32例(35.6%)。DR诊断周围型肺癌的敏感性、特异性及准确性分别为85%、81%、85.6%,而CT则为90%,87.6%,90.5%,均高于DR。DR与CT两者联合诊断周围型肺癌的敏感性为98.4%,显著高于DR(85%)和CT(90%)。结论:在早期周围型肺癌的影像学诊断中,CT的临床价值显著优于DR,而两者联合诊断的临床价值明显优于单独检测。

Objective： To analyze the diagnostic value of digital radiography （DR）, CT and DR combined with CT for the peripheral lung cancer. Methods： 90 cases of patients with early peripheral lung cancer from February 2012 to March 2016 were selected as the research object. Digital radiography （DR）, CT scanning were preformed in 90 cases of peripheral lung carcinoma ascertained by surgery and/or pathology. The sensibility, specificity, PPV, NPV, accuracy of DR, CT and DR combined with CT in the diagnosis of peripheral lung cancer were analyzed and compared. Results： 7 cases （7.8%） ofvocule sign, 47 cases of lobulation （52.2%）, 36 cases （40%） of the edge of a fine little prick, 9 cases （10%） ofpleural indentation were found by DR detection. CT checked up the lesion edge lobulation in 71 cases （78.8%）, the length of the burr syndrome in 57 cases （63.3%）, empty sign 27 cases （30%）, pleural cavity Depression syndrome in 32 cases （35.6%）. The specificity and accuracy of DR in the diagnosis of peripheral lung cancer were 85%, 81%, 85.6%, and CT were 90%, 87.6%, 90.5%. While the sensitivity, specificity and accuracy of diagnostic CT were higher than DR. The diagnostic sensitivity of DR combined with CT was 98.4%, which was significantly higher than DR （85%） and CT （90%）. Conclusion： The diagnostic value of CT was more excellent than DR for the early peripheral lung cancer,while the clinical value of DR combined with CT was higher than DR and CT.