低剂量螺旋CT扫描诊断早期肺癌的价值

The value of low-dose spiral CT in the diagnosis of early lung cancer

目的探讨低剂量螺旋CT扫描诊断早期肺癌的价值.方法选择2019年5月-2021年5月阳江市阳东区人民医院收治的疑似早期肺癌患者76例作为研究对象,全部患者均行低剂量螺旋CT扫描检查,并于3d后进行常规CT扫描检查,以病理检查结果为"金标准",分析并对比常规剂量、低剂量CT扫描检查诊断早期肺癌的准确度、特异度、灵敏度、阴性预测值(NPV)、阳性预测值(PPV),并对比两种扫描方式下放射剂量、肿瘤形态学特征.结果76例疑似早期肺癌患者经病理检查可知,45例确诊为早期肺癌,占59.21%;常规剂量、低剂量螺旋CT扫描检查准确度、特异度、灵敏度、PPV、NPV对比,差异无统计学意义(P>0.05);低剂量CT扫描检查剂量长度乘积、最大有效辐射剂量均低于常规剂量,差异有统计学意义(P<0.05);两种扫描检查下,毛刺征、钙化征、分叶征、空洞征占比对比,差异无统计学意义(P>0.05).结论相较常规CT扫描检查,低剂量螺旋CT扫描检查可降低辐射剂量,且早期肺癌检查准确度与常规CT检查结果相似,安全性更好.

Objective To evaluate the diagnostic value of low-dose spiral CT in early lung cancer.Methods 76 patients with suspected early lung cancer admitted to our hospital from May 2019 to May 2021 were selected as the study subjects.All patients underwent low-dose spiral CT scan,and routine CT scan was performed 3 days later.Pathological examination results were regarded as the"gold standard".The accuracy,specificity,sensitivity,negative predictive value(NPV)and positive predictive value(PPV)of conventional dose and lowdose CT scanning in the diagnosis of early lung cancer were analyzed and compared,and the radiation dose and tumor morphological characteristics under the two scanning methods were compared.Results Pathological examination showed that 45 cases(59.21%)were diagnosed as early lung cancer.There was no significant difference in accuracy,specificity,sensitivity,PPV and NPV between conventional dose and low-dose spiral CT(P>0.05).The dose length product and maximum effective radiation dose of low-dose CT scan were lower than those of conventional dose,and the differences were statistically significant(P<0.05).There was no significant difference in the proportions of burr sign,calcification sign,lobulation sign and cavity sign between the two scans(P>0.05).Conclusion Compared with conventional CT scan,low-dose spiral CT scan can reduce the radiation dose,and the accuracy of early lung cancer detection is similar to that of conventional CT,and the safety is better.