CT双入口灌注成像鉴别良恶性肺结节临床应用

Clinical Application of CT Dual-input Perfusion Imaging in Differential Diagnosis of Benign and Malignant Pulmonar y Nodules

目的探讨320排CT双入口灌注成像鉴别良恶性肺结节临床应用。方法回顾性分析2017年4月至2020年4月本院收治并经病理学证实或临床随访后证实的80例肺结节患者的临床资料,其中良性结节患者42例(良性结节组),恶性结节患者38例(恶性结节组),均行320排CT双入口灌注扫描,测定肺结节支气管动脉血流量(BF)、肺动脉血流量(PF)及灌注指数(PI),并与最终结果进行对照分析。结果恶性结节组平扫值、强化值及增强峰值均高于良性结节组(P<0.05);恶性结节组BF高于良性结节组,PF和PI低于良性结节组(P<0.05);320排CT双入口灌注参数诊断良恶性肺结节的准确性为93.75%,敏感度为94.74%,特异度为97.50%;PI诊断恶性肺结节的ROC曲线下面积为0.779,最佳诊断阈值为58.23,敏感度为91.36%,特异度为68.19%。结论320排CT双入口灌注成像在鉴别良恶性肺结节中具有重要作用。

Objective To explore the clinical application of 320-slice CT dual-input perfusion imaging in differential diagnosis of benign and malignant pulmonary nodules.Methods The clinical data of 80 patients with pathologically confirmed pulmonary nodules who were admitted and treated in the hospital between April 2017 to April 2020 were retrospectively analyzed.42 patients with benign nodules were included in the benign group,and 38 patients with malignant nodules were included in the malignant group.All patients completed 320-slice CT dual-input perfusion scanning to determine the bronchial arterial blood flow(BF),pulmonary arterial blood flow(PF)and perfusion index(PI)of pulmonary nodules.Then,the results were compared with pathological findings.Results The plain scan value,enhancement value and enhancement peak of malignant group were higher than that of benign group(P<0.05).BF of malignant group was higher than that of benign group,but PF and PI were lower than benign group(P<0.05).The accuracy,sensitivity and specificity of 320-slice CT dual-input perfusion parameters in diagnosis of benign and malignant pulmonary nodules were 93.75%,94.74%and 97.50%,respectively.The area under the ROC curve of PI in differential diagnosis of benign and malignant pulmonary nodules was 0.779.The optimal diagnostic threshold,sensitivity and specificity were 58.23,91.36%and 68.19%,respectively.Conclusion 320-slice CT dual-input perfusion imaging plays an important role in differential diagnosis of benign and malignant pulmonary nodules.