256层极速CT平扫及三期增强扫描在肺癌诊断中的应用观察

Study on the Application of 256-Slice Ultra-Fast CT Plain Scan and Three-Stage Enhanced Scan in the Diagnosis of Lung Cancer

目的:探讨256层极速CT平扫及三期增强扫描在肺癌诊断中的应用价值。方法:回顾性分析2016年1月~2020年12月本院收治的疑似肺癌患者96例临床资料,入选患者均进行256层极速CT平扫及三期增强扫描。以病理结果作为金标准,分析256层极速CT平扫及三期增强扫描诊断肺癌的结果。结果:96例疑似肺癌患者经病理确诊为恶性肿瘤的共58例,余38例为良性病变;三期动态增强扫描诊断肺癌灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于CT平扫,差异有统计学意义(P<0.05);CT平扫诊断肺癌与手术病理结果一致性较差(Kappa=0.415),三期动态增强扫描诊断肺癌与手术病理结果一致性较高(Kappa=0.891);不同病理类型CT净增强值相比,小细胞肺癌<腺癌<鳞状细胞癌,差异有统计学意义(P<0.05)。结论:与CT平扫相比,256层极速三期增强扫描诊断肺癌准确度、灵敏度、特异度均更高,便于临床作出准确判断,为临床治疗、评估预后提供更多有价值的参考信息,具有较高的应用价值。

Objective:To investigate the application value of 256-slice ultra-fast CT plain scan and three-stage enhanced CT scan in the diagnosis of lung cancer.Methods:The clinical data of 96 patients with suspected lung cancer admitted to our hospital from January 2016 to December 2020 were retrospectively analyzed.All the enrolled patients underwent 256-slice ultra-fast CT plain scan and three-stage enhanced CT scan.Using the pathological results as the gold standard,the results of diagnosis of lung cancer by 256-slice ultra-fast CT plain scan and three-stage enhanced scan were analyzed.Results:Of the 96 suspected lung cancer patients,58 were diagnosed as malignant tumors by pathology,and the remaining 38 were benign lesions.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of three-stage dynamic enhanced scan in the diagnosis of lung cancer were all higher than those of plain CT scan,with statistical significance(P<0.05).The consistency between CT plain scan diagnosis of lung cancer and surgical pathology results was poor(Kappa=0.415),while the consistency between phase III dynamic enhanced scan diagnosis of lung cancer and surgical pathology results was high(Kappa=0.891).Compared with CT net enhancement value of different pathological types,small cell lung cancer<adenocarcinoma<squamous cell carcinoma,the difference was statistically significant(P<0.05).Conclusion:Compared with plain CT scan,256-slice ultra-fast phase III enhanced scan has higher accuracy,sensitivity and specificity in the diagnosis of lung cancer,which is convenient for clinical diagnosis and can provide more valuable reference information for clinical treatment and prognosis evaluation.Therefore,it has high application value.