CT灌注成像在肺炎性结节与肺癌鉴别诊断中的价值

发布时间：2018-05-17 03:34

本文选题：肺炎 + 体层摄影术　；参考：《中华医院感染学杂志》2017年11期

【摘要】：目的分析计算机体层成像(CT)灌注成像在肺炎性结节与肺癌鉴别诊断中的价值。方法选择医院2014年1月-2015年12月进行CT灌注成像检查的30例肺炎患者为肺炎组和30例肺癌患者为肺癌组,对所有患者进行全肺CT灌注成像检测。结果肺炎组有2种时间-密度曲线类型,A型时间-密度曲线逐渐上升至最大值后缓慢上升,B型时间-密度曲线上升和下降均比较缓慢;肺癌组有4种时间-密度曲线类型,A型时间-密度曲线上升迅速,上升至最大值后略有下降或者缓慢下降,B型时间-密度曲线上升迅速,上升到峰值后下降,下降到一定程度后维持在平直状态,C型时间-密度曲线逐渐上升至峰值后不下降,维持在平直状态,D型时间-密度曲线逐渐上升至峰值后继续缓慢上升,肺炎A型时间-密度曲线和肺癌C型时间-密度曲线相似,但肺炎的增强幅度明显高于肺癌;肺炎组血流量和毛细血管通透性(9.32±2.56ml/min.100mg、9.97±1.48ml/min.100g)均低于肺癌组(27.53±14.37ml/min.100mg、22.10±8.94ml/min.100g),差异有统计学意义(P0.05);血流量阈值为15.02时,鉴别肺炎和肺癌的ROC曲线下面积为0.83,灵敏度和特异度分别为67.90%和100.00%;毛细血管通透性的阈值为14.04时,鉴别肺炎和肺癌的ROC曲线下面积为0.84,灵敏度和特异度分别为82.10%和100.00%;CT灌注诊断肺炎和肺癌的灵敏度为73.30%,特异度为96.70%,诊断符合率为85.00%,误诊率为3.30%,漏诊率为26.70%,约登指数为70.00%。结论 CT灌注成像在肺炎性结节的诊断及其与肺癌的鉴别诊断中具有一定临床价值。
[Abstract]:Objective to analyze the value of CT perfusion imaging in differential diagnosis of pulmonary nodule and lung cancer. Methods from January 2014 to December 2015, 30 patients with pneumonia and 30 patients with lung cancer were examined by CT perfusion imaging. Results in pneumonia group, there were two types of time-density curve: the time-density curve of type A gradually increased to the maximum value, and then the curve of time-density increased slowly and the curve of time-density of type B increased slowly. There were four types of time-density curve in lung cancer group. The time-density curve of type A increased rapidly, then decreased slightly or decreased slowly after rising to the maximum value. The curve of time-density of type B increased rapidly and then decreased after reaching the peak value. After decreasing to a certain extent, the time-density curve of C type in a flat state gradually rose to the peak value, and then did not decrease, while the D type time-density curve in a straight state gradually increased to the peak value and then continued to rise slowly. The time-density curve of type A pneumonia was similar to that of type C lung cancer, but the enhancement of pneumonia was significantly higher than that of lung cancer. The blood flow and capillary permeability in pneumonia group were lower than those in lung cancer group (9.32 卤2.56 ml / min. 100 mg / min 9.97 卤1.48 ml / min. 100 g), respectively. The difference was statistically significant (P 0.05), compared with that in lung cancer group (27.53 卤14.37 ml / min. 100 mg / min = 22.10 卤8.94 ml / min 路100 g / g). The area under the ROC curve was 0.83.The sensitivity and specificity were 67.90% and 100.000.The threshold of capillary permeability was 14.04. The area under the ROC curve for differentiating pneumonia from lung cancer was 0.84, the sensitivity and specificity of CT perfusion diagnosis of pneumonia and lung cancer were 82.10% and 100.0010%, respectively, the sensitivity was 73.30 and the specificity was 96.70, the diagnostic coincidence rate was 85.00, the misdiagnosis rate was 3.30, the missed diagnosis rate was 26.70 and the Yorden index was 70.0070. Conclusion CT perfusion imaging has some clinical value in the diagnosis of pneumonic nodules and its differential diagnosis with lung cancer.
【作者单位】：宁波市奉化区人民医院放射科;
【基金】：浙江省医药卫生一般研究计划基金资助项目(2015KYB412)
【分类号】：R563.1;R730.44;R734.2

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