高分辨CT在脾脏占位性病变诊断及鉴别诊断中的应用价值分析

Application value of high resolution CT in the diagnosis and differential diagnosis of splenic space-occupying lesions

目的 探讨高分辨CT在脾脏占位性病变诊断及鉴别诊断中的应用价值。方法 采用excel表格对2021年1月—2023年10月东莞市横沥医院放射科收治的60例病例资料(疾病:脾脏占位性病变)进行统计,均实施常规CT平扫、高分辨CT检查,以病理诊断结果为金标准,分析各个方案的检出情况、诊断效能。结果 以病理诊断结果为金标准,常规CT平扫检查恶性检出率为63.64%、良性检出率为81.58%;高分辨CT检查恶性检出率为90.91%、良性检出率为97.37%。常规CT平扫检查对各疾病检出率为75.00%,高分辨CT检查对各疾病检出率为95.00%,对比差异有统计学意义(P<0.05)。高分辨CT检查敏感度(95.24%)、特异度(94.87%)、准确率(95.00%)、阳性预测值(90.91%)、阴性预测值(97.37%)与常规CT平扫检查对比差异有统计学意义(P<0.05)。以病理诊断为金标准,常规CT平扫检查Kappa指数0.612,高分辨CT检查Kappa指数0.897。结论 在脾脏占位性病变诊断中应用高分辨CT进行检查既可明确疾病类型、性质,亦可提升诊断准确率及灵敏度,为临床医师制定治疗方案提供参考,值得借鉴。

Objective To investigate the application value of high resolution CT in the diagnosis and differential diagnosis of splenic space-occupying lesions.Methods The data of 60 cases(disease:splenic space-occupying lesion)admitted to the Radiology department of Hengli Hospital in Dongguan City from January 2021 to October 2023 were analyzed using excel tables.Routine CT plain scan and high-resolution CT were performed for all cases.The detection and diagnostic effectiveness of each scheme were analyzed with pathological diagnosis results as the gold standard.Results Taking the pathological diagnosis as the gold standard,the detection rate of malignant and benign were 63.64%and 81.58%respectively by conventional CT plain scan.The detection rate of malignant was 90.91%and that of benign was 97.37%.The detection rate of routine CT and high-resolution CT were 75.00%and 95.00%respectively,with statistical significance(P<0.05).The sensitivity(95.24%),specificity(94.87%),accuracy(95.00%),positive predictive value(90.91%),negative predictive value(97.37%)of high-resolution CT were significantly different from those of conventional CT scan(P<0.05).With pathological diagnosis as the gold standard,Kappa index was 0.612 by conventional CT and 0.897 by high-resolution CT.Conclusion The application of high-resolution CT in the diagnosis of splenic space-occupying lesions can not only clarify the type and nature of the disease,but also improve the diagnostic accuracy and sensitivity,which can provide references for clinicians to make treatment plans.