周围型肺癌的CT和MRI表现特点研究

Study on CT and MRI Features of Peripheral Lung Cancer

目的探讨CT联合MRI诊断周围型肺癌的疾病特征及诊断效能。方法选取2016年1月至2019年12月我院收治的76例周围型肺癌患者,对其进行CT与MRI检查,观察分析两种检查图像,比较其内部结构显示、周围特征性表现、病变情况及肿瘤检出率。结果CT对直径<3cm和3~5cm肿瘤内部结构显示优于MRI检查(P<0.05),CT与MRI对直径>5cm内部显示结构差异无统计学差异(P>0.05)。患者周围特征性表现为分叶征、棘突征、毛刺征及血管集束征。CT检查对肿瘤直径<3cm和3~5cm周围特征情况显示优于MRI(P<0.05),CT与MRI对直径>5cm周围特征表现差异无统计学差异(P>0.05)。CT检出钙化、血管断面误诊及胸膜凹陷征情况优于MRI(P<0.05);MRI检出淋巴结、积液、胸膜胸椎等侵袭情况优于CT(P<0.05)。CT检出率为40.79%,MRI检出率为43.42%,CT联合MRI检出率为89.47%,CT与MRI单独检查检出率差异无统计学意义(P>0.05);CT联合MRI检出率显著高于两者单独检查(P<0.05)。结论CT为周围型肺癌检查的首选方式,可清晰显示肿瘤部位及周围特征;MRI为新型影像学检查方式,相对于CT可提供清晰的有关淋巴结及病灶侵犯图像,能为疾病诊断提供更多依据,CT联合MRI检查能提高肿瘤检出率和准确率,及早诊断出周围型肺癌以便患者及时治疗,提高其预后情况。

Objective To investigate the characteristics and diagnostic efficacy of CT combined with MRI in the diagnosis of peripheral lung cancer.Methods 76 patients with peripheral lung cancer admitted to our hospital from January 2017 to December 2019 were selected.All patients received CT and MRI examinations.Images of two methods were analyzed,and the internal structure,peripheral characteristics,pathological changes,and tumor detection rates were compared.Results CT was superior to MRI in displaying the internal structure of tumors with diameter less than 3cm and 3-5cm(P<0.05),while the two methods showed no significant difference in internal structure display of tumors with diameter more than 5cm(P>0.05).The peripheral characteristics of tumor included lobular sign,spines,spiculation sign,and vascular convergence sign.CT was superior to MRI in displaying the peripheral characteristics of tumors with diameter less than 3cm and 3~5cm(P<0.05),while the two methods showed no significant difference in peripheral characteristics display of tumors with diameter more than 5cm(P>0.05).CT was better than MRI in detecting calcification,misdiagnosis of vascular section and pleural depression(P<0.05).The invasion of lymph nodes,effusion,pleura or thoracic vertebrae detected by MRI was better than that of CT(P<0.05).The detection rate of CT combined with MRI was significantly higher than that of single detection of CT or MRI(89.47%vs 40.79%,43.42%,P<0.05),while the detection rate of CT had no difference with that of MRI(P>0.05).Conclusion CT is the preferred method of examination,which can clearly show the tumor site and surrounding characteristics of peripheral lung cancer.As a new imaging method,MRI can provide clear images of lymph nodes and lesion invasion,which can provide more bases for disease diagnosis,so combination of the two CT can improve the detection and accuracy rates,moreover,early diagnosis and timely treatment can improve the prognosis.