64层增强CT三维重建对肺内磨玻璃密度影早期肺癌的诊断价值

Diagnostic value of 64-row contrast-enhanced CT with three-dimensional reconstruction in early lung cancer with ground-glass opacity

目的探讨64层增强CT三维重建(3D成像)对肺内磨玻璃密度影(GGO)早期肺癌的诊断价值。方法收集2018年3-10月郑州大学第一附属医院收治的影像学表现符合GGO的52例手术患者(36例术后病理为肺腺癌,分期为T1M0N0;16例术后病理为良性)为研究对象,所有患者均于术前接受64层CT增强扫描并经图像后处理工作站进行3D重建。对比恶性GGO中三维图像与轴位图像在影像学上的表现以及轴位图像和3D图像对GGO早期肺癌的敏感度、特异度、准确度,分析三维重建对GGO早期肺癌的诊断价值。结果 36例恶性GGO中,64层CT增强扫描三维重建对恶性肿瘤征象(分叶征、毛刺征、血管集束征)的检出率均高于轴位成像,差异有统计学意义(均P<0.05);64层CT增强扫描三维重建的敏感度、特异度、准确度均高于轴位成像,差异有统计学意义(均P<0.05)。结论 64层增强CT三维重建对GGO早期肺癌具有良好的诊断价值。

Objective To investigate the diagnostic value of 64-row contrast-enhanced CT with three-dimensional reconstruction (3D imaging) in early lung cancer with ground-glass opacity (GGO). Methods A total of 52 surgical patients with imaging findings consistent with GGO were enrolled from March to October 2018 in the First Affiliated Hospital of Zhengzhou University (36 patients with pathologically lung adenocarcinoma, staged T 1M 0N 0;16 patients with benign pathology). All patients underwent a 64-row spiral CT enhancement scan before surgery, and a 3D reconstruction via an image post-processing workstation was conducted. The imaging performances of three-dimensional images and axial images in malignant GGO as well as the sensitivity, specificity and accuracy of axial images and 3D images on early lung cancer with GGO were compared. The diagnostic value of three-dimensional reconstruction in early lung cancer with GGO was analyzed. Results Among 36 cases of malignant GGO, the detection rates of malignant tumor signs (lobular sign, spiculation sign, vessel convergence sign) of 64-slice CT enhanced scan three-dimensional recosnstruction were all higher than those of axial imaging, and the differences were statistically significant (all P < 0.05). The sensitivity, specificity and accuracy of 64-slice CT enhanced scan three-dimensional reconstruction were higher than those of axial imaging, and the differences were statistically significant (all P < 0.05). Conclusion The 64-slice CT three-dimensional reconstruction has a good diagnostic value for early lung cancer with GGO .