多层螺旋CT三维重建后处理在肿瘤样病变中的鉴别诊断价值

Differential diagnostic value of multi-slice spiral CT 3D reconstruction in tumor like lesions

目的:探讨多层螺旋CT三维重建后处理在肿瘤样病变中的鉴别诊断价值。方法:采用回顾性研究方法,选择2013年2月至2017年1月在我院进行诊治的肺部肿块患者235例作为研究对象,其中病理诊断为肿瘤样病变35例(肿瘤样病变组)和恶性肿瘤200例(肿瘤组),记录两组的多层螺旋CT特征与三维重建后处理灌注参数,判定诊断价值。结果:肿瘤样病变组的病灶最大径为(3.11±1.24)cm,增强幅值为(27.33±8.19)Hu;肿瘤组分别为(5.68±1.49)cm和(31.40±9.44)Hu,对比差异都有统计学意义(P<0.05)。肿瘤样病变组的病灶BV、BF与PS值分别为(2.84±1.93)ml·100 g-1、(2.14±1.33)ml·min-1·100 g-1和(12.89±5.29)ml·min-1·100 g-1,都明显低于肿瘤组病灶的(33.87±11.49)ml·100 g-1、(25.39±12.49)ml·min-1·100 g-1和(127.40±34.91)ml·min-1·100 g-1(P<0.05)。在235例患者中,CT判断为肿瘤样病变30例,恶性肿瘤205例,为此多层螺旋CT三维重建后处理在肿瘤样病变鉴别诊断中敏感性与特异性为100.0%和97.6%。结论:多层螺旋CT三维重建后处理在肿瘤样病变中的应用有很好的应用效果,能清楚显示病灶情况,能通过灌注参数进行病情判断,是鉴别肺部肿瘤样病变与恶性肿瘤的重要依据。

Objective： To investigate the values of multi - slice spiral CT 3D reconstruction in differential diagno-sis of tumor like lesions. Methods：With a retrospective study,from February 2013 to January 2017,235 cases of lung mass in our hospital for diagnosis and treatment were selected as the research object that included the pathological di-agnosis of 35 cases of tumor like lesions （ tumor like lesion group） and 200 cases of malignant tumor （tumor group）.The characteristics of the two groups of multi - slice spiral CT and 3D reconstruction postprocessing perfusion parame-ters were recorded,and diagnostic values were evaluated. Results： The maximum diameter of lesion in tumor like le-sion group was （3. 11 ±1.24） cm,and the enhancement amplitude was （27.33 ±8. 19） Hu,and （5.68 ±1.49） cm and （31.40 ±9. 44） Hu in the tumor group and the difference compared between the two groups was statistically significant （ P 〈 0. 05 ） . The BV, BF and PS values of lesions in tumor like lesions were （ 2. 84 ± 1. 93 ） ml · 100 g-1,（2. 14 ± 1.33） ml . min-1 · 100 g-1 and （ 12. 89 ±5. 29） ml· min-1 . 100 g-1,which were significantly lower than those in tumor group with （ 33. 87 ± 11.49） ml·100 g-1 , （25. 39 ± 12.49） ml· min-1· 100 g-1 and （ 127. 40 ± 34. 91） ml · min 1 · 100 g 1 （ P 〈 0. 05 ） . In the 235 patients, CT was diagnosed as tumor like lesions in 30 cases and malignant tumors in 205 cases. For this purpose,the diagnosis sensitivity and specificity of multi - slice CT 3D re-construction in tumor like lesions were 100. 0% and 97. 6% . Conclusion： The multi - slice spiral CT 3D reconstruc-tion in diagnostic of tumor like lesions has good effect. It can clearly show the lesions,and it can better judge the se-verity of illness through the perfusion parameters. It is an important basis for identification of pelvic tumor like lesions and malignant tumors.