CT增强扫描在肺癌诊断和淋巴结转移评估中的应用效果

The Application Effect of Enhanced CT Scanning in the Diagnosis of Lung Cancer and Evaluation of Lymph Node Metastasis

目的:探究CT增强扫描在肺癌诊断和淋巴结转移评估中的应用效果。方法:回顾性分析2020年4月~2022年4月本院收治的87例肺占位性病变患者的临床资料,均接受CT平扫和增强扫描,以病理学诊断结果为金标准评估CT增强扫描诊断肺癌及淋巴结转移的应用效果,并比较不同病理类型及淋巴结转移患者的扫描CT值及强化增值。结果:87例肺占位性病变患者中检出51例恶性病变,36例良性病变,其中炎性假瘤19例,炎性肉芽肿12例,结核球5例,CT平扫诊断肺癌的灵敏度为68.63%、特异度为69.44%、阳性预测值为76.09%、阴性预测值为60.98%、准确率为68.97%、Kappa值为0.373,CT增强扫描诊断肺癌的灵敏度为80.39%、特异度为83.33%、阳性预测值为87.23%、阴性预测值为75.00%、准确率为81.61%及Kappa值为0.627;良性病变患者增强扫描CT值及CT净增强值均存在统计学差异(P<0.05);51例肺癌患者中34例患者有淋巴结转移,无淋巴结转移17例,增强CT扫描诊断淋巴结转移的灵敏度为64.70%、特异度为82.35%、阳性预测值为88.00%、阴性预测值为53.85%、准确率为70.59%、Kappa值为0.416。结论:CT增强扫描能有效区分肺占位病变的良恶性,同时在淋巴结转移评估中也有一定的参考价值。

Objective:To explore the application effect of enhanced CT scanning in the diagnosis of lung cancer and evaluation of lymph node metastasis.Methods:A retrospective analysis was conducted on the clinical data of 87 patients with pulmonary space occupying lesions admitted to the hospital from April 2020 to April 2022.All patients underwent plain and enhanced CT scans,and the clinical efficacy of enhanced CT scans in diagnosing lung cancer and lymph node metastasis was evaluated based on pathological diagnosis results as the gold standard,cement of patients with different pathological types and lymph node metastasis.Results:Out of 87 patients with pulmonary space occupying lesions,51 were malignant and 36 were benign.Among them,19 were inflammatory pseudotumors,12 were inflammatory granulomas,and 5 were tuberculoma.The sensitivity of CT plain scan in diagnosing lung cancer was 68.63%,specificity was 69.44%,positive predictive value was 76.09%,negative predictive value was 60.98%,accuracy was 68.97%,and Kappa value was 0.373.The sensitivity of CT enhanced scan in diagnosing lung cancer was 80.39%,specificity was 83.33%,the positive predictive value was 87.23%,the negative predictive value was 75.00%,the accuracy was 81.61%and the Kappa value was 0.627;There were statistical differences in the CT values and net CT enhancement values of enhanced scans in patients with benign lesions(P<0.05);Among 51 lung cancer patients,34 had lymph node metastasis and 17 had no lymph node metastasis.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy,and Kappa value of enhanced CT scanning in diagnosing lymph node metastasis were 64.70%,82.35%,88.00%,53.85%,70.59%,and 0.416,respectively.Conclusion:CT enhanced scanning can effectively distinguish between benign and malignant lung masses,and also has certain reference value in the evaluation of lymph node metastasis.