|
| HRCT靶向增强扫描对肺部磨玻璃小结节良恶性的诊断价值研究 |
| The value of HRCT targeted contrast-enhanced scan in the diagnosis of benign and malignant pulmonary small ground glass nodules |
| 投稿时间：2024-06-11 修订日期：2024-08-10 |
| DOI： |
|
 |
| 中文关键词: 磨玻璃结节 计算机体层成像 靶向扫描 鉴别诊断 |
| 英文关键词:ground glass nodules computed tomography targeted scanning differential diagnosis |
| 基金项目:浙江省中医药科技计划项目(2020ZB117) |
|
| 摘要点击次数: 50 |
| 全文下载次数: 0 |
| 中文摘要: |
| 目的：探讨高分辨率CT(HRCT)靶向增强扫描对于肺部磨玻璃小结节(6mm≤最大径≤10mm)良、恶性的预测价值。方法：回顾性分析浙江中医药大学附属第二医院自2018年1月至2023年6月收治的经常规CT检查发现肺部磨玻璃小结节患者89例,行HRCT靶向增强扫描检查。根据手术、穿刺或随访结果分成良性组(n=47例)和恶性组(n=42例),评估每个病灶的影像特征,通过单因素分析及多因素 Logistic 回归分析确定恶性结节的独立预测因素并构建预测模型,采用受试者工作特征(ROC)曲线分析诊断性能。两名医师(一名住院医师和一名主治医师)现场阅片,通过 Kappa 检验分析医师诊断结果与手术病理结果的一致性。 结果：多因素 Logistic 分析显示血管集束征和内部血管增粗为恶性肺部磨玻璃小结节的独立预测因素,差异有统计学意义(P < 0. 05)。联合上述特征构建预测模型用于鉴别肺小结节的良、恶性ROC曲线下面积为0.966(95%CI: 0.904-0.933),敏感度为95.24%(95%CI: 83.8%-99.4%),特异度为87.23%(95%CI: 74.3%-95.2%)。对照病理结果,住院医生的常规CT的Kappa值为0.63,HRCT靶向增强的Kappa值为0.72；主治医师的常规CT和HRCT靶向增强Kappa值分别为0.72和0.82,与常规CT比较,HRCT靶向扫描的医师诊断结果与病理结果的一致性均有所提高。结论：HRCT靶向增强扫描有利于对肺部磨玻璃样小结节的良、恶性进行鉴别诊断,指导临床决策,减少不必要的随访。 |
| 英文摘要: |
| objective to evaluate the value of high resolution CT (HRCT) targeted enhanced scan in predicting benign and malignant pulmonary ground glass nodules (6mm≤maximum diameter≤ 10mm). Methods 89 patients with pulmonary ground glass nodules found by routine CT from January 2018 to June 2023 were retrospectively analyzed. HRCT targeted enhanced scanning was performed. According to the results of operation, puncture or follow-up, the patients were divided into benign group (n = 47) and malignant group (n = 42). The imaging features of each lesion were evaluated. The independent predictors of malignant nodules were determined by univariate analysis and multivariate Logistic regression analysis. The diagnostic performance was analyzed by receiver operating characteristic (ROC) curve.SThe Kappa test was used to analyze the consistency between the diagnosis of doctors and the results of operation and pathology. Results multivariate logistic analysis showed that vascular convergence sign and internal vascular thickening were independent predictors of malignant pulmonary small ground glass nodules. Combined with the above characteristics, the area under the ROC curve of benign and malignant pulmonary nodules was 0.966 (95%CI: 0.904-0.933), the sensitivity was 95.24% (95%CI: 0.838-0.994), and the specificity was 87.23% (95%CI: 0.743-0.952). Compared with the pathological results, the Kappa of conventional CT of residents was 0.63, and the Kappa of targeted enhancement of HRCT was 0.72 and 0.82. Compared with routine HRCT, the diagnostic results of HRCT were more consistent with pathological results. Conclusion Targeted enhanced HRCT scan could help to differentiate benign and malignant pulmonary small ground glass nodules, guide clinical decision-making and reduce unnecessary follow-up. |
|
在线阅读
查看/发表评论 下载PDF阅读器 |
|
|
|