多层螺旋CT扫描对肺磨玻璃结节的诊断价值

Diagnostic value of multi-slice spiral CT in pulmonary ground-glass nodule imaging indicators

目的:探究多层螺旋CT (multi-slice spiral CT,MSCT)扫描对肺磨玻璃结节的诊断价值。方法:回顾性分析2019年8月—2021年7月中煤矿建总医院收治的120例肺磨玻璃结节患者的临床资料,所有患者均行MSCT检查。分析MSCT检查及病理检查结果,对比不同性质肺磨玻璃结节的影像学特征、不同性质肺磨玻璃结节患者病灶情况,以病理检查结果为诊断“金标准”,分析MSCT在肺磨玻璃结节中的诊断价值。结果:经病理学检查明确良性结节38例,恶性结节82例;MSCT扫描明确良性结节42例,恶性结节78例。恶性结节分叶征、毛刺征、边界不清、胸膜凹陷征发生率均高于良性结节,差异有统计学意义(P<0.05)。相比于良性结节,恶性结节病灶直径及实性病灶直径均较大,差异有统计学意义(P<0.05)。MSCT诊断肺磨玻璃结节灵敏度为93.90%、特异度为97.37%、准确率为95.00%、阳性预测值为98.72%、阴性预测值为88.10%,Kappa检验显示:MSCT与“金标准”结果高度一致(Kappa=0.888)。结论:MSCT扫描在肺磨玻璃结节诊断中应用价值较高,经MSCT扫描可明确病变处的影像学特点,为临床诊疗提供更加可靠的参考,值得推广应用。

Objective To explore the diagnostic value of multi-slice spiral CT(MSCT) in pulmonary ground-glass nodules.Methods Clinical data of 120 patients with pulmonary ground-glass nodules admitted to Zhong Mei Kuang Jian General Hospital from August 2019 to July 2021 were retrospectively analyzed,and all patients underwent MSCT examination.The results of MSCT examination and pathological examination were analyzed,and the imaging characteristics and lesions of patients with different properties of pulmonary ground-glass nodules were compared.The diagnostic value of MSCT in pulmonary ground-glass nodules was analyzed by taking pathological examination results as the "gold standard" for diagnosis.Results Pathological examination confirmed 38 cases of benign nodules and 82 cases of malignant nodules;MSCT showed 42 benign nodules and 78 malignant nodules.The incidence of lobulation sign,burr sign,unclear border and pleural indentation sign in malignant nodules was higher than that in benign nodules,with statistical difference(P <0.05).Compared with benign nodules,the diameters of malignant nodules and solid nodules were larger,with statistical difference(P <0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of MSCT were 93.90%,97.37%,95.00%,98.72% and 88.10% respectively.Kappa test showed that MSCT was highly consistent with the "gold standard" results(Kappa=0.888).Conclusion MSCT scanning is of high value in the diagnosis of pulmonary ground-glass nodule.MSCT scanning can clarify the imaging characteristics of the lesions and provide a more reliable reference for clinical diagnosis and treatment,which is worth popularizing.