DCE-CT与MRI在周围型肺癌诊断中的效能比较

Comparison of efficacies of DCE-CT and MRI in diagnosis of peripheral lung cancer

目的:比较动态增强CT(DCE-CT)与磁共振成像(MRI)在周围型肺癌诊断中的效能。方法:选取2018年1月至2022年3月该院收治的114例疑似周围型肺癌患者进行前瞻性研究,均进行病理学检查、MRI、DCE-CT,以病理学检查结果为金标准,比较MRI、DCE-CT在周围型肺癌诊断中的效能(准确度、灵敏度、特异度、漏诊率、误诊率、阳性预测值、阴性预测值)和周围型肺癌病灶特征(空泡征、空气支气管征、棘突征、毛刺征、血管集束征、分叶征)检出率。结果:病理学检查结果显示,114例疑似周围型肺癌患者中阳性81例,阴性33例;DCE-CT诊断周围型肺癌的准确度、灵敏度、阴性预测值高于MRI,漏诊率低于MRI,差异有统计学意义(P<0.05);MRI、DCE-CT诊断周围型肺癌的特异度、误诊率、阳性预测值比较,差异无统计学意义(P>0.05);DCE-CT棘突征、毛刺征、血管集束征、分叶征、空泡征和空气支气管征检出率高于MRI,差异有统计学意义(P<0.05)。结论:DCE-CT诊断周围型肺癌的准确度、灵敏度、阴性预测值以及棘突征、毛刺征、血管集束征、分叶征、空泡征和空气支气管征检出率高于MRI,漏诊率低于MRI。

Objective:To compare efficacies of dynamic contrast-enhanced CT(DCE-CT)and magnetic resonance imaging(MRI)in diagnosis of peripheral lung cancer.Methods:A prospective study was conducted on 114 patients with suspected peripheral lung cancer admitted to the hospital from January 2018 to March 2022.All patients underwent pathological examination,MRI and DCE-CT.Using the results of pathological examination as the gold standard,the efficacies of MRI and DCE-CT in the diagnosis of peripheral lung cancer(accuracy,sensitivity,specificity,missed diagnosis rate,misdiagnosis rate,positive predictive value,negative predictive value)and the detection rate of peripheral lung cancer lesion characteristics(vacuole sign,air bronchogram sign,spinous process sign,burr sign,vascular convergence sign,lobulation sign)were compared.Results:Among the 114 patients with suspected peripheral lung cancer,81 cases were positive and 33 cases were negative by the pathological examination.The accuracy,the sensitivity and the negative predictive value of DCE-CT in the diagnosis of peripheral lung cancer were higher than those of MRI,the missed diagnosis rate was lower than that of MRI,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the specificity,the misdiagnosis rate,and the positive predictive value between MRI and DCE-CT in the diagnosis of peripheral lung cancer(P>0.05).The detection rates of spinous process sign,burr sign,vascular convergence sign,lobulation sign,vacuole sign and air bronchogram sign of DCE-CT were higher than those of MRI,and the differences were statistically significant(P<0.05).Conclusions:The accuracy,the sensitivity,the negative predictive value,and the detection rate of the spinous process sign,the burr sign,the vascular convergence sign,the lobulation sign,the vacuole sign and the air bronchogram sign of DCE-CT in the diagnosis of peripheral lung cancer are higher than those of MRI;however,the missed diagnosis rate is lower than that of MRI.