CT与X线检查诊断肺部孤立性球形病变的价值比较

Comparison of the value of CT and X-ray in the diagnosis of solitary spherical lesions of the lung

目的分析肺部孤立性球形病变应用CT与X线检查的效果。方法71例肺部孤立性球形病变患者,均实施X线检查及CT检查。对比两种检查方式对肺部孤立性球形病变各病理类型的检出率及对肺部孤立性球形病变的诊断结果。结果CT检查的肺结核、肺癌检出率及肺部孤立性球形病变总检出率分别为100.00%、100.00%、95.77%,高于X线检查的69.23%、58.33%、74.65%,差异具有统计学意义(P<0.05);两种检查方式的炎性病变、良性肿瘤及其他检出率对比,差异无统计学意义(P>0.05)。将病理学诊断结果作为金标准,以炎性病变、肺结核、肺癌以及良性肿瘤等作为阳性病变(65例),以其他病变作为阴性病变(6例)。CT检查对肺部孤立性球形病变的诊断特异度为83.33%(5/6)、灵敏度为96.92%(63/65),阴性预测值为71.43%(5/7)、阳性预测值为98.44%(63/64),X线检查对肺部孤立性球形病变的诊断特异度为66.67%(4/6)、灵敏度为75.38%(49/65),阴性预测值为20.00%(4/20)、阳性预测值为96.08%(49/51)。CT检查对肺部孤立性球形病变的诊断灵敏度及阴性预测值均明显高于X线检查,差异具有统计学意义(P<0.05);两种检查方式对肺部孤立性球形病变的诊断特异度、阳性预测值对比,差异无统计学意义(P>0.05)。结论临床进行肺部孤立性球形病变鉴别及诊断时应根据患者临床症状及影像学表现进行综合判断,为肺部孤立性球形病变患者实施CT检查能够使病变检出率得到显著提高,同时还能够为临床对病变类型进行准确辨别提供依据。

Objective To analyze the effects of CT and X-ray for patients with solitary spherical lesions of the lungs.Methods 71 patients with isolated spherical lesions of the lung were studied,and both X-ray and CT examinations were performed on the patients.The detection rates of the two examination methods for various pathological types of solitary spherical lesions in the lungs and their diagnostic results for solitary spherical lesions of the lungs were compared.Results The detection rates of pulmonary tuberculosis,lung cancer and the total detection rate of isolated spherical lesions in the lung were 100.00%,100.00% and 95.77% by CT examination,which were higher than 69.23%,58.33% and 74.65% by X-ray examination,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the detection rates of inflammatory lesions,benign tumors and others between the two examination methods(P>0.05).Pathological diagnostic findings were used as the gold standard,with inflammatory lesions,pulmonary tuberculosis,lung cancer,and benign tumors as positive lesions(65 cases)and other lesions as negative lesions(6 cases).The diagnostic specificity of CT examination for isolated spherical lesions of the lung was 83.33%(5/6),sensitivity was 96.92%(63/65),negative predictive value was 71.43%(5/7),and positive predictive value was 98.44%(63/64);the diagnostic specificity of X-ray examination for isolated spherical lesions in the lung was 66.67%(4/6),sensitivity was 75.38%(49/65),negative predictive value was 20.00%(4/20)and positive predictive value was 96.08%(49/51).The diagnostic sensitivity and negative predictive value of CT examination for solitary spherical lesions of the lung were significantly higher than those of X-ray examination,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the diagnostic specificity and positive predictive value of the two examination methods for solitary spherical lesions of the lung(P>0.05).Conclusion The clinical identification and diagnosis of solitary spherical lesions of the lung should be based on the patient's clinical symptoms and imaging findings.CT examinations for patients with solitary spherical lesions of the lung can significantly improve the detection rate of the lesions while providing a basis for accurate clinical differentiation of lesion types.