多层螺旋CT与HRCT对周围型肺癌的临床诊断价值分析

Analysis of clinical diagnostic value of multi-slice spiral CT and HRCT for peripheral lung cancer

目的探究多层螺旋CT与高分辨率CT(HRCT)在周围型肺癌中的临床诊断价值。方法选取2017年8月至2019年12月本院收治的122例疑似周围型肺癌患者,所有患者均行多层螺旋CT及HRCT检查。以穿刺或手术病理结果作为诊断周围型肺癌的金标准,分析病理结果,比较多层螺旋CT及HRCT在周围型肺癌中的诊断结果,并分析两种检查方法与病理诊断的一致性。结果122例疑似患者中,经病理结果明确为周围型肺癌阳性98例,阴性24例;多层螺旋CT诊断周围型肺癌阳性89例,阴性33例;HRCT诊断周围型肺癌阳性93例,阴性29例。HRCT在周围型肺癌诊断中灵敏度为91.84%、特异度为87.50%、准确度为90.98%,均高于多层螺旋CT的80.61%、58.33%、76.23%,差异有统计学意义(P<0.05)。Kappa检验显示,多层螺旋CT与病理检查的一致性不佳(Kappa=0.341,P=0.000);HRCT与病理检查的一致性尚可(Kappa=0.736,P=0.000)。结论多层螺旋CT及HRCT均可准确诊断周围型肺癌,但HRCT诊断效能更高,可作为诊断周围型肺癌的首选检查方式。

Objective To explore the clinical diagnostic value of multi-slice spiral CT and high-resolution CT(HRCT)in peripheral lung cancer.Methods 122 patients with suspected peripheral lung cancer admitted to our hospital from August 2017 to December 2019 were selected.All pa-tients underwent mult-slice spiral CT and HRCT examination.The pathological results of puncture or surgery were taken as the gold standard for the diagnosis of peripheral lung cancer,and the pathological results were analyzed.Furthermore,the diagnostic results of multi-slice spiral CT and HRCT in peripheral lung cancer were compared,and the consistency between the two examination methods and the pathological diagnosis were ana-lyzed.Results Among 122 suspected patients,98 cases were confirmed as positive for peripheral lung cancer by pathological results,while 24 cas-es were negative.89 cases were confirmed as positive for peripheral lung cancer by multi-slice spiral CT results,while 33 cases were negative.93 cases were positive for peripheral lung cancer and 29 cases were negative by HRCT results.The sensitivity,specificity and accuracy of HRCT in the diagnosis of peripheral lung cancer were 91.84%,87.50%and 90.98%,which were all higher than 80.61%,58.33%and 76.23%of multi-slice spiral CT,the difference was statistically significant(P<0.05).Kappa test showed that there was poor consistency between MDCT and pathologi-cal examination(Kappa=0.341,P=0.000).The consistency between HRCT and pathological examination was acceptable(Kappa=0.736,P=0.000).Conclusion Both multi-slice spiral CT and HRCT can accurately diagnose peripheral lung cancer,but HRCT has higher diagnostic efficiency,so it can be used as the first choice for diagnosis of peripheral lung cancer.