高分辨率CT征象对肺部磨玻璃结节良恶性的鉴别诊断价值

Diagnostic value of high-resolution CT sign in differentiating benign and malignant pulmonary ground-glass nodules

目的研究高分辨率CT征象对肺部磨玻璃结节良恶性鉴别的价值。方法回顾性分析20例肺部磨玻璃结节患者的临床资料,所有患者均进行高分辨率CT检测,分析高分辨率CT诊断和病理诊断结果,比较肺部磨玻璃样结节良恶性患者的高分辨率CT征象,以病理诊断为金标准,分析高分辨率CT对恶性肺部磨玻璃样结节的诊断效能。结果120例肺部磨玻璃结节患者经病理诊断确诊良性78例(65.00%),恶性42例(35.00%),经高分辨率CT检出良性82例(68.33%),恶性38例(31.67%)。恶性患者高分辨率CT显示病灶形态不规则占比81.57%、毛刺征占比63.16%、分叶征占比68.42%、囊状透亮影占比36.84%、病灶边界模糊占比84.21%、密度混合占比60.53%均高于良性患者的54.88%、41.46%、18.29%、14.63%、12.20%、17.07%,差异均具有统计学意义(P<0.05)。而良、恶性患者的病灶大小、空泡征、支气管征、血管束征、胸膜凹陷征占比比较,差异均无统计学意义(P>0.05)。高分辨率CT鉴别恶性肺部磨玻璃结节的阳性预测值、阴性预测值、敏感度、特异度、准确度、约登指数、误诊率、漏诊率分别为97.37%、93.90%、88.10%、98.72%、95.00%、0.8682、1.28%、11.90%。结论通过高分辨率CT诊断肺部磨玻璃结节可有效区分结节良恶性,为临床的诊断和治疗工作提供科学依据。

Objective To study the value of high-resolution CT sign in differentiating benign and malignant pulmonary ground-glass nodules.Methods The clinical data of 20 patients with pulmonary groundglass nodules were retrospectively analyzed.High-resolution CT detection was performed in all patients,and the results of high-resolution CT and pathology were analyzed.The high-resolution CT signs of benign and malignant pulmonary ground-glass nodules were compared,and the diagnostic efficacy of high-resolution CT for malignant pulmonary ground-glass nodules was analyzed with pathological diagnosis as the gold standard.Results 120 patients with pulmonary ground-glass nodules were diagnosed pathologically as benign in 78 cases(65.00%)and malignant in 42 cases(35.00%);high-resolution CT detected 82 benign cases(68.33%)and 38 malignant cases(31.67%).High-resolution CT showed that 81.57%of malignant patients had irregular lesions,63.16%had spiculation sign,68.42%had lobulation sign,36.84%had cystic lucency shadow,84.21%had blurred lesion boundary,and 60.53%had mixed density,which were higher than 54.88%,41.46%,18.29%,14.63%,12.20%,and 17.07%of benign patients,and the differences were statistically significant(P<0.05).There was no statistically significant difference between benign and malignant patients in lesion size,and proportion of vacuole sign,bronchial sign,vascular bundle sign and pleural indentation sign(P>0.05).The positive predictive value,negative predictive value,sensitivity,specificity,accuracy,Jordan index,misdiagnosis rate and missed diagnosis rate of high-resolution CT in differentiating malignant pulmonary ground-glass nodules were 97.37%,93.90%,88.10%,98.72%,95.00%,0.8682,1.28%and 11.90%,respectively.Conclusion High-resolution CT diagnosis of pulmonary ground-glass nodules can effectively differentiate between benign and malignant nodules,and provide a scientific basis for clinical diagnosis and treatment.