CT全瘤灌注参数在对肺癌与肺良性病变鉴别诊断中的应用

发布时间：2018-03-23 14:15

本文选题：肺癌　切入点：肺良性病变　出处：《广东医学》2017年S1期

【摘要】：目的探讨多层螺旋CT全瘤灌注参数对肺癌及肺良性病变鉴别诊断的应用价值。方法对初诊61例肺内单发直径2 cm的肿块性病变进行前瞻性CTPI,通过CT灌注后处理得出血流量(BF)、血容积(BV)、平均通过时间(MTT)、透析度(PMB)4个灌注参数,并使用SPSS 22.0统计软件进行统计学分析。结果 (1)肺癌病灶与肺良性病变灌注参数比较,BV、MTT、PMB的差异有统计学意义(P0.05);BF差异无统计学意义(P0.05)。(2)肺癌与肺良性病变CT全瘤灌注参数(BF、BV、MTT、PMB)ROC曲线下面积分别为0.596、0.806、0.705、0.961。BF的最大约登指数为0.324,此时BF值49.13 m L/(100 m L·min),敏感度为80.00%,特异度为52.40%,阳性预测值为75.34%,阴性预测值为59.03%。BV的最大约登指数为0.510,此时为BV值6.67 m L/100 m L,敏感度为70%,特异度为81.00%,阳性预测值为87.17%,阴性预测值为60.57%。MTT的最大约登指数为0.499,此时MTT值3.83 s,敏感度为97.50%,特异度为52.40%,阳性预测值为78.83%,阴性预测值为92.05%。PMB的最大约登指数指数为0.830,此时PMB值7.28 m L/(100 m L·min),敏感度为92.50%,特异度为90.50%,阳性预测值为94.65%,阴性预测值为86.91%。结论 CT全瘤灌注参数对肺癌和肺良性病变的鉴别诊断有较大的帮助。4个灌注参数中,以BV及PMB的鉴别效能较好且以PMB最佳。
[Abstract]:Objective to evaluate the value of multislice spiral CT perfusion parameters in the differential diagnosis of lung cancer and benign lung diseases. Methods 61 cases of lung tumor with a diameter of 2 cm in diameter were treated with CTPI prospectively and treated with CT perfusion. The blood volume, mean transit time (MTT) and dialysis degree (PMB) were four parameters. SPSS 22.0 statistical software was used for statistical analysis. Results the perfusion parameters of lung cancer focus and benign lung disease were compared. There was no significant difference in the perfusion parameters between lung cancer focus and benign lung disease. There was no significant difference in SPSS T T T SPSS between lung cancer and benign lung disease (P 0.05%, P 0.05%, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P < 0.05, P 0.05). The maximum Jordan index of the area under the ROC curve is 0.596 / 0.806 / 0.705 / 0.961.BF, which is 49.13 mL / 100 mL / min, sensitivity is 80.00m / L, specificity is 52.40m, positive predictive value is 75.34, the maximum Jorden index of negative predictive value is 0.510, and the BV value is 6.67 m. The sensitivity of L / 100 mL, sensitivity, specificity, positive predictive value and negative predictive value are 87.17 and 0.499, respectively. At this point, MTT is 3.83 s, sensitivity is 97.50, specificity is 52.40, positive predictive value is 78.83 and negative predictive value is about the largest of 92.05%.PMB. The Deng index is 0.830, and the PMB value is 7.28 mL / 100 mL 路min ~ (-1), sensitivity is 92.50, specificity is 90.50, positive predictive value is 94.65 and negative predictive value is 86.91.Conclusion CT perfusion parameters are of great help in the differential diagnosis of lung cancer and benign lung diseases. Of the 4 perfusion parameters, BV and PMB were the most effective and PMB was the best.
【作者单位】：广州医科大学附属第一医院放射科;
【基金】：广东省科技计划项目(编号:2014A020212608)
【分类号】：R563;R730.44;R734.2

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