CT征象与Lung-RADS分级对孤立性肺结节良恶性鉴别价值

Value of CT Signs and Lung-RADS Grading in Distinguishing Benign and Malignant Solitary Pulmonary Nodules

目的探讨肺部影像报告和数据系统(Lung-RADS分级)、CT征象对孤立性肺结节良恶性鉴别价值。方法选取2019年10月-2021年4月在我院确诊的84例孤立性肺结节患者,所有患者均经病理组织学确诊良性38例,恶性46例。分别对84例患者实施Lung-RADS分级、CT检查。以病理诊断为“金标准”,采用kappa一致性分析比较Lung-RADS分级和CT征象对孤立性肺结节良恶性的鉴别诊断价值。结果CT诊断敏感度为82.61%,特异度为86.84%,准确度为84.52%,恶性预测值为88.37%,良性预测值为80.49%,Kappa值为0.690;Lung-RADS分级诊断敏感度为76.09%,特异度为73.68%,准确度为75.00%,恶性预测值为77.78%,良性预测值为71.79%,Kappa值为0.497;联合两种方法诊断孤立性肺结节的敏感度为86.96%,特异度为89.47%,准确度为88.10%,恶性预测值为90.91%,良性预测值为85.00%,Kappa值为0.761。结论CT征象联合Lung-RADS分级对孤立性肺结节良恶性鉴别价值较高,与“金标准”具有较高的一致性。

Objective To explore the value of lung imaging-reporting and data system(Lung-RADS grading)and CT signs in distinguishing benign and malignant solitary pulmonary nodules(SPN).Methods A total of 84 patients with SPN confirmed in the hospital were enrolled between October 2019 and April 2021.There were 38 benign cases and 46 malignant cases confirmed by pathological histology.All underwent Lung-RADS grading and CT examination.Taking pathological diagnosis as the golden standard,the value of Lung-RADS grading and CT signs in the differential diagnosis of benign and malignant SPN was compared by Kappa consistency analysis.Results The sensitivity,specificity,accuracy,malignant predictive value,benign predictive value and Kappa value of CT diagnosis were 82.61%,86.84%,84.52%,88.37%,80.49%and 0.690,respectively.The sensitivity,specificity,accuracy,malignant predictive value,benign predictive value and Kappa value of Lung-RADS grading were 76.09%,73.68%,75.00%,77.78%,71.79%and 0.497,respectively.the sensitivity of combining the two methods to diagnose solitary pulmonary nodule is 86.96%,The sensitivity,specificity,accuracy,malignant predictive value,benign predictive value and Kappa value of CT combined with Lung-RADS grading were 86.96%,89.47%,88.10%,90.91%,85.00%and 0.761,respectively.Conclusion CT signs combined with Lung-RADS grading is of high value in distinguishing benign and malignant SPN,whose consistency is high with the golden standard.