CT联合MRI检查在纵隔型肺癌诊断中的影像特征及效能

Imaging features and efficacy of CT combined with MRI in diagnosis of mediastinal lung cancer

目的:观察CT联合磁共振成像(MRI)检查在纵隔型肺癌诊断中的影像特征及效能。方法:选取72例纵隔肿瘤患者为研究对象,入院后均行CT、MRI检查,并以手术病理检查结果为“金标准”,比较CT、MRI单项及联合检查在纵隔型肺癌诊断中的影像特征及价值。结果:手术病理学检查结果为72例纵隔肿瘤患者中良性肿瘤44例,均为原发性纵隔肿瘤;恶性肿瘤28例,均为纵隔型肺癌。Kappa检验结果显示,CT检查诊断纵隔型肺癌结果与手术病理学检查结果的一致性一般(Kappa=0.630,P=0.000);MRI检查诊断纵隔型肺癌结果与手术病理学检查结果的一致性一般(Kappa=0.692,P=0.000);CT联合MRI检查诊断纵隔型肺癌结果与手术病理学检查结果的一致性较好(Kappa=0.913,P=0.000)。CT联合MRI检查诊断纵隔型肺癌的准确度、灵敏度均较高于CT、MRI单项检查,差异有统计学意义(P<0.05);CT、MRI单项及联合检查诊断纵隔型肺癌的特异度比较,差异无统计学意义(P>0.05)。纵隔型肺癌CT检查的影像特征:肿块均发生结节状改变,边缘不规则,多呈毛刺状、分叶状,可伴有支气管闭塞或狭窄征象,肿块内部脂肪线增强,增强扫描时表现为不均匀强化。纵隔型肺癌MRI检查的影像特征与CT检查相似。结论:CT联合MRI检查诊断纵隔型肺癌的准确度、灵敏度均较高于CT、MRI单项检查诊断,且与手术病理学检查结果一致性较好。

Objective: To observe the imaging features and efficacy of computed tomography(CT) combined with magnetic resonance imaging(MRI) in diagnosis of mediastinal lung cancer. Methods: 72 patients with mediastinal neoplasms were selected as the research subjects.CT and MRI examinations were performed after admission. Using the results of surgical and pathological examinations as the “gold standard”, the imaging features and values of single CT examination, single MRI examination and combined examination in the diagnosis of mediastinal lung cancer were compared. Results: The results of surgical and pathological examination showed that among the 72 patients with mediastinal neoplasms,44 were benign tumors, all of which were primary mediastinal tumors;28 were malignant tumors, all of which were mediastinal lung cancer. The Kappa test showed that the results of CT in the diagnosis of mediastinal lung cancer were in fair consistent with the results of surgical pathology(Kappa=0.630, P=0.000);the results of MRI in the diagnosis of mediastinal lung cancer were in fair consistent with the results of surgical pathology(Kappa=0.692, P=0.000);the results of CT combined with MRI in the diagnosis of mediastinal lung cancer were in good agreement with the results of surgical pathology(Kappa=0.913, P=0.000). The accuracy and sensitivity of CT combined with MRI in the diagnosis of mediastinal lung cancer were higher than those of single CT and MRI examinations, and the differences were statistically significant(P<0.05). However, there were no significant differences in the specificity of single CT and MRI examinations and CT combined with MRI in the diagnosis of mediastinal lung cancer(P>0.05).The imaging features of CT examination of mediastinal lung cancer were nodular changes in all masses, irregular margins, mostly spiculated and lobulated, accompanied by signs of bronchial occlusion or stenosis, enhanced fat line with the mass and heterogeneous enhancement when the enhanced scan was used. The imaging features of MRI examination of mediastinal lung cancer are similar to those of CT examination. Conclusions:The accuracy and sensitivity of CT combined with MRI in the diagnosis of mediastinal lung cancer are higher than those of single CT and MRI examinations. Moreover, its results are in good agreement with those of surgical and pathological examinations.