MSCT扫描检查对周围型肺癌TNM分期诊断符合率的影响

Effect of MSCT Scan on Diagnostic Coincidence Rate of TNM Staging in Peripheral Lung Cancer

目的探讨多层螺旋CT(MSCT)扫描检查对周围型肺癌TNM分期诊断符合率的影响。方法选取光山县人民医院2018年11月至2019年11月收治的周围型肺癌患者58例,先行X线检查,再行MSCT扫描,观察2种检查方式的周围型肺癌阳性检出率、周围型肺癌TNM分期诊断符合率及MSCT下周围型肺癌影像学特征。结果与X线检查比较,MSCT周围型肺癌阳性检出率显著升高,漏诊率显著降低,差异有统计学意义(均P<0.05);MSCT检查周围型肺癌T、N、M分期诊断符合率为91.38%(53/58)、93.10%(54/58)、13.79%(8/58),显著高于X线检查的63.79%(37/58)、68.97%(40/58)、0.00%(0/58),差异有统计学意义(χ^2=12.691,χ^2=10.994,χ^2=6.579;P<0.001,P<0.001,P=0.010);MSCT下周围型肺癌影像学特征:病灶平均直径为(1.96±0.57)cm,可见分叶征、毛刺征、棘突征、血管集束征、空泡征、支气管充气征、空洞征等多种征象。结论MSCT可显著提高周围型肺癌阳性检出率,准确判断TNM分期,并可显示病灶征象及其周边形态特征,有助于周围型肺癌鉴别诊断和预后评估。

Objective To investigate the effect of multi-slice spiral CT(MSCT)scan on the diagnostic coincidence rate of TNM staging in peripheral lung cancer.Methods Fifty-eight peripheral lung cancer patients admitted to our hospital from November 2018 to November 2019 underwent X-ray examination and MSCT scan.The positive detection rate,diagnostic coincidence rate of TNM staging and MSCT features were observed.Results Compared with X-ray examination,MSCT increased the positive detection rate and decreased the missed diagnosis rate in peripheral lung cancer(P<0.05).the diagnosis rates of T,N,and M stages of peripheral lung cancer by MSCT were respectively 91.38%(53/58),93.10%(54/58)and 13.79%(8/58),significantly higher than those by X-ray(63.79%(37/58),68.97%(40/58)and 0.00%(0/58),respectively)(χ^2=12.691,χ^2=10.994 andχ^2=6.579,respectively;P<0.001,P<0.001 and P=0.010,respectively).MSCT characteristics included lobulation sign,burr sign,spinous process sign,vascular cluster sign,vacuole sign,bronchial inflation sign and cavity sign.The average lesion diameter was(1.96±0.57)cm.Conclusion MSCT can significantly improve the positive detection rate of peripheral lung cancer,accurately determine the TNM stage,and display the lesion signs and peripheral morphological features.Therefore,MSCT can contribute to the differential diagnosis and prognostic evaluation of peripheral lung cancer.