周围型肺癌在多层螺旋CT诊断中的影像学表现与术后病理学诊断的一致性分析

Imaging Findings of Peripheral Lung Cancer in Multi-slice Spiral CT Diagnosis and Its Consistency with Postoperative Pathological Diagnosis

目的观察周围型肺癌(peripheral lung cancer,PLC)在多层螺旋CT(multisliecs helieal CT,MSCT)诊断中的影像学表现,并分析其与术后病理学诊断的一致性。方法选取我院收治的78例经病理证实的肺癌患者,术前均行MSCT诊断,以术后病理学为"金标准",观察MSCT诊断PLC的结果与其一致性,总结PLC在MSCT诊断中的影像学表现。结果MSCT诊断PLC灵敏度86.67%,特异度84.85%,准确性85.90%,Kappa值0.71;MSCT诊断正确的39例PLC患者影像学表现为:12例(30.77%)不规则斑片阴影,27例(69.23%)圆形或者类圆形阴影;13例(33.33%)为实质高密度影,18例(46.15%)为低密度影,8例(20.51%)密度不均匀;16例(41.02%)呈现磨砂玻璃样结节,7例(17.95%)呈现蜂房样结节,9例(23.08%)空泡征样结节,7例(17.95%)呈现软组织密度结节;3例(7.69%)边缘光滑整齐,36例(92.31%)表现不光滑平整清晰(毛刺征、分叶征以及小泡征分别为13例、18例、5例);凹陷征与血管集束征分别为23例(58.97%)、16例(41.03%)。结论MSCT诊断PLC与术后病理学诊断结果具有较高一致性,掌握PLC MSCT影像学表现,可为PLC早期诊治提供有效依据。

Objective To observe the imaging findings of peripheral lung cancer(PLC) in multi-slice spiral CT(MSCT) diagnosis, and to analyze its consistency with postoperative pathological diagnosis. Methods A total of 78 patients pathologically confirmed with lung cancer who were admitted to the hospital were enrolled. All patients underwent MSCT before operation. Taking the postoperative pathology as golden standard, the consistency between MSCT and postoperative pathology for the diagnosis of PLC was observed. The imaging findings of PLC in MSCT diagnosis were summarized. Results The sensitivity, specificity, accuracy and Kappa value of MSCT for the diagnosis of PLC were 86.67%, 84.85%, 85.90% and 0.71, respectively. The imaging findings of 39 PLC patients who were correctly diagnosed by MSCT were as follows: There were 12 cases(30.77%) with irregular patch shadows, 27 cases(69.23%) with round or round-like shadows, 13 cases(33.33%) with substantially high-density shadows, 18 cases(46.15%) with low-density shadows, 8 cases(20.51%) with uneven density, 16 cases(41.02%) with ground glass-like nodules, 7 cases(17.95%) with hive-like nodules, 9 cases(23.08%) with vacuolizationsign nodules, 7 cases(17.95%) with soft tissue density nodules, 3 cases(7.69%) with smooth and tidy edges and 36 cases(92.31%) showing unsmooth, flat and clear status(13 cases, 18 cases and 5 cases with burr sign, lobulation sign and vesicle sign, respectively). There were 23 cases(58.97%) and 16 cases(41.03%) with sulcus sign and vessel convergence sign, respectively. Conclusion The consistency between MSCT and postoperative pathology is relatively higher for diagnosis of PLC. Mastering MSCT imaging findings of PLC can provide effective basis for early diagnosis and treatment of PLC.