16排螺旋CT及三维重建在肺结节性病变诊断中的应用

Application of 16-slice spiral CT and three-dimensional reconstruction in diagnosis of pulmonary nodule lesion

目的探讨16排螺旋CT及三维重建在肺结节性病变诊断及鉴别诊断中的应用价值。方法选取本院2016年1月至2018年12月收治的肺结节性病变患者65例,所有患者均行16排螺旋CT平扫及三维重建,以病理诊断结果为“金标准”,评估16排螺旋CT平扫及三维重建诊断肺结节性病变的灵敏度、特异度及准确度;对比分析良恶性结节动态增强CT值。结果经手术病理诊断65例肺结节病变中,46例恶性结节,19例良性结节。较16排螺旋CT平扫相比,16排螺旋CT三维重建恶性检出率高,差异具有统计学意义(P<0.05);16排螺旋CT三维重建诊断肺结节性病变灵敏度、特异度及准确度均高于16排螺旋CT平扫,差异具有统计学意义(P<0.05);恶性结节动态增强30 s、90 s、480 s CT值均高于良性结节,差异具有统计学意义(P<0.05)。结论相较于16排螺旋CT平扫,三维重建技术可从多方位、多层面显示结节特征,为临床诊断肺结节性病变提供重要依据。

Objective To investigate the application value of 16-slice spiral CT and three-dimensional(3D)reconstruction in diagnosis and differential diagnosis of pulmonary nodule lesion.Methods 65 patients of pulmonary nodule lesion who admitted in the hospital from January 2016 to December 2018 were selected as subjects.All patients underwent 16-slice spiral CT plain scan and 3D reconstruction.The pathological diagnosis results were taken as the gold standard.The sensitivity,specificity,accuracy of 16-slice spiral CT plain scan and 3D reconstruction in diagnosis of pulmonary nodule lesion were evaluated;The dynamic enhanced CT value of benign or malignant nodule was compared.Results Of 65 cases of pulmonary nodule lesion diagnosed by surgical pathology,there were 46 cases of malignant nodules and 19 cases of benign nodules.Compared with 16-slice spiral CT plain scan,the malignant detection rate of 16-slice spiral CT 3D reconstruction was higher,and the difference was statistically significant(P<0.05);The sensitivity,specificity,accuracy of 16-slice spiral CT 3D reconstruction were higher than those of 16-slice spiral CT plain scan,and the difference was statistically significant(P<0.05);The dynamic enhanced 30 s,90 s,480 s CT values of malignant nodules were higher than that of benign nodules,and the difference was statistically significant(P<0.05).Conclusion Compared with 16-slice spiral CT plain scan,3D reconstruction can display nodular features from multiple directions and layers,which provides important basis for clinical diagnosis of pulmonary nodule lesion.