低剂量电子计算机断层扫描在孤立性肺结节随访中的价值分析

The Value of Low-dose Computed Tomography in the Follow-up of Isolated Pulmonary Nodules

目的探讨低剂量电子计算机断层扫描(CT)在孤立性肺结节随访中的价值。方法选取90例孤立性肺结节患者均采用普通X线摄影与低剂量CT随访4个月,以穿刺活检结果作为金标准,比较普通X线摄影与低剂量CT在孤立性肺结节中的随访价值。结果穿刺活检结果作为金标准,其中肺癌50例(55.56%)、肺炎性假瘤33例(33.67%)、肺结核瘤7例(7.77%);低剂量CT对肺癌、肺炎性假瘤及肺结核瘤诊断符合率较普通X线摄影诊断高(P<0.05);低剂量CT敏感性、特异性、阳性预测值及阴性预测值均较普通X线摄影高(P<0.05),且与金标准的一致性好(Kappa值=0.888,P<0.05)。结论低剂量CT在孤立性肺结节随访中的诊断价值较高,可作为优先随访工具。

Objective To investigate the value of low-dose computed tomography(CT)in the followup of isolated pulmonary nodules.Methods 90 patients with isolated pulmonary nodules were selected as study subjects.All patients were followed up for 4 months with normal X-ray photography and low-dose CT.The result of puncture biopsy was taken as the gold standard to compare the follow-up value of normal X-ray photography and low-dose CT in isolated pulmonary nodules.Results There were 50 cases of lung cancer(55.56%),33 cases of pneumonic pseudotumor(33.67%)and 7 cases of pulmonary tuberculosis(7.77%)among the 90 patients with solitary pulmonary nodules.The diagnostic coincidence rates of low-dose CT for lung cancer,pneumonic pseudotumor and pulmonary tuberculosis were higher and than that of conventional X-ray imaging(P<0.05).The sensitivity,specificity,positive predictive value and negative predictive value of lowdose CT were higher than those of conventional X-ray photography(P<0.05),and were in good agreement with the Gold standard(Kappa value=0.888,P<0.05).Conclusion Low-dose CT has a higher diagnostic value in the follow-up of isolated pulmonary nodules and can be used as a priority follow-up tool.