多层螺旋CT多平面重建后处理技术对肺内占位良恶性的鉴别诊断意义

Multi-slice spiral CT multi-planar reconstruction and post-processing technique for differential diagnosis of benign and malignant lesions in the lung

目的:探讨多层螺旋CT多平面重建后处理技术对肺内占位良恶性的鉴别诊断意义。方法:2016年5月到2018年6月选择在我院进行诊治的肺内占位病变患者194例,所有患者均给予常规多层螺旋CT与CT多平面重建后处理技术检查,记录影像学特征,并判断鉴别诊断良恶性的效果。结果:在194例患者中,病理诊断为良性病变100例(良性组),诊断为恶性病变94例(恶性组),恶性组与良性组CT常规特征中的分叶征、锯齿征、毛刺征、血管聚集征、空泡征等比例差异显著(P<0.05)。所有患者CT多平面重建后处理图像均可清晰显示肺动脉,不同重建方法显示肺部血管有高度一致性,重建评分对比差异无统计学意义(P>0.05)。多层螺旋CT多平面重建后处理鉴别诊断肺内占位病变良恶性的阳性预测值、阴性预测值、灵敏度以及特异度分别为90.5%、91.9%、91.5%和91.0%。结论:多层螺旋CT多平面重建后处理技术在肺内占位病变中的应用获取图像清晰,重建区域自由,能有效鉴别诊断良恶性状况。

Objective:To investigate the differential diagnosis of benign and malignant lesions in the lung by multi-slice spiral CT multi-planar reconstruction.Methods:From May 2016 to June 2018,194 patients with intrapulmonary lesions were selected and treated in our hospital.All patients were given conventional multi-slice spiral CT multi-planar reconstruction,recorded the features,and were to judge the effects of differential diagnosis of benign and malignant.Results:In the 194 patients,there were 100 patients were pathologically diagnosed as benign lesions(benign group),and 94 patients were diagnosed as malignant lesions(malignant group).The proportion of lobular sign,sawtooth sign,burr sign,and vascular aggregation in the malignant group were significantly lower than that of the benign group by the conventional CT(P<0.05).Pulmonary arteries were clearly displayed in all patients with CT multiplanar reconstruction,and the different reconstruction methods were all showed high degree of consistency in the pulmonary vessels.There were no significant difference compared between the reconstruction scores(P>0.05).The sensitivity,specificity,negative predictive values and the positive predictive value of the multi-planar reconstruction after multi-slice reconstruction were 91.5%,91.0%,91.9%and 90.5%,respectively.Conclusion:The multi-slice spiral CT multi-planar reconstruction technique in the application of lung space-occupying lesions have clear avatar and free reconstruction area,which can effectively distinguish between benign and malignant conditions.