CT三维重建图像对恶性肺内孤立性结节的诊断价值

发布时间：2018-07-12 11:29

本文选题：孤立性结节 + 体层摄影术　；参考：《广东医学》2015年02期

【摘要】：目的用logistic回归与受试者工作曲线(ROC曲线)分析评价CT三维重建图像对恶性孤立性肺结节(SPN)的诊断价值,得出三维图像中有利于判断结节良恶性的征象,建立多因素回归模型预测SPN的良恶性,使三维重建技术在SPN方面更好地服务于临床。方法对98例SPN患者进行多平面重建、最大密度投影、曲面重建和容积再现等方法重建后,分析三维重建图像,并与病理随访结果对照进行统计学处理。采用单因素和多因素回归分析探求各征象对SPN恶性度的辨识能力,并绘制ROC曲线来检验回归曲线的诊断效能。结果单因素分析显示,毛刺征者60例(61.2%)、深分叶征者64例(65.3)、支气管截断征46例(46.9%)、胸膜凹陷征66例(67.3%)、血管集束征67例(68.4%),以上5种征象为恶性SPN相关因素(P0.05)。多因素分析显示,分叶征、毛刺征、血管集束征、支气管截断征为恶性SPN的征象。上述征象ROC曲线下面积分别为0.726、0.665、0.717、0.638、0.878。结论毛刺征、分叶征、血管集束征和气管截断征对恶性SPN有一定的诊断意义,多参数回归模型对诊断恶性SPN较有一定的临床价值。
[Abstract]:Objective to evaluate the diagnostic value of CT 3D reconstruction images for malignant solitary pulmonary nodules (SPNs) by using logistic regression and operating curve (ROC curve) analysis, and to find out that 3D images are helpful for the diagnosis of benign and malignant nodules. The multivariate regression model was established to predict the benign and malignant SPN, which made 3D reconstruction better serve the clinical use of SPN. Methods 98 patients with SPN underwent multiplanar reconstruction, maximum density projection, curved surface reconstruction and volume reconstruction. The 3D reconstruction images were analyzed and compared with the results of pathological follow-up. Single factor and multivariate regression analysis were used to explore the ability of identifying the malignant degree of SPN, and the ROC curve was drawn to test the diagnostic effectiveness of the regression curve. Results univariate analysis showed that 60 cases (61.2%) had burr sign, 64 cases (65.3%) had deep lobulation sign, 46 cases (46.9%) had bronchial truncation sign, 66 cases (67.3%) had pleural depression sign, 67 cases (68.4%) had vascular cluster sign. The above five signs were associated with malignant SPN (P0.05). Multivariate analysis showed that lobulation sign, burr sign, vascular cluster sign and bronchial truncation sign were the signs of malignant SPN. The areas under the ROC curve were 0.726 / 0.665and 0.717 / 0.638 / 0.878, respectively. Conclusion Spurs sign, lobulation sign, vascular cluster sign and tracheal truncation sign have certain diagnostic significance for malignant SPN. Multi-parameter regression model has certain clinical value in the diagnosis of malignant SPN.
【作者单位】：海南医学院附属医院放射科;
【基金】：海南省医学科研立项课题(编号:琼卫2010-53) 海南医学院大学生创新性实验项目(编号:HYCX201119) 海南医学院国家大学生创新创业训练计划项目(编号:201211810053)
【分类号】：R734.2;R730.44

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