多层螺旋CT灌注成像正增强积分及达峰时间在孤立性肺结节鉴别诊断中的应用

发布时间：2018-05-30 15:41

本文选题：CT灌注 + 孤立性肺结节　；参考：《广东医学》2015年23期

【摘要】：目的探讨多层螺旋CT肺灌注成像中正增强积分(PEI)及达峰时间(TTP)在孤立性肺结节良恶性诊断中的应用价值。方法收集孤立性肺结节患者53例,利用GE64层螺旋CT对患者进行肺灌注扫描,灌注扫描图像用GE AW4.4工作站中CT perfusion 4.0软件进行后处理,分别记录感兴趣区、强化峰值曲线、PEI及TTP,对其中的PEI及TTP进行数据分析。结果 53例患者中,灌注成功37例,其中恶性结节25例,良性结节12例,肺内恶性结节PEI均值为52.91(22.77,92.09),良性结节PEI均值为13.73(9.93,23.27),差异有统计学意义(P0.05);恶性结节TTP为(24.75±11.47)s,良性结节TTP为(18.43±7.61)s,差异无统计学意义(P0.05)。PEI对于鉴别肺结节良恶性有诊断价值,TTP尚无诊断价值;以28.66作为PEI鉴别诊断良恶性结节的最佳诊断临界值,其敏感度为84.00%,特异度为83.33%,准确度为83.18%,阳性预测值为91.30%,阴性预测值为71.42%。结论多层螺旋CT肺灌注成像中PEI可以作为一种鉴别孤立性肺结节良恶性的参考指标,TTP在鉴别孤立性肺结节良恶性中尚不具备较高价值。
[Abstract]:Objective to evaluate the value of positive enhanced integral (PEI) and TTP in the diagnosis of benign and malignant solitary pulmonary nodules in multislice spiral CT pulmonary perfusion imaging. Methods 53 patients with solitary pulmonary nodules were examined by GE64 slice spiral CT. The perfusion images were processed by CT perfusion 4.0 software of GE AW4.4 workstation, and the regions of interest were recorded. The PEI and TTP data were analyzed by strengthening the peak curve of PEI and TTP. Results among 53 patients, 37 cases were successfully perfused, including 25 cases of malignant nodules and 12 cases of benign nodules. The mean value of PEI in malignant nodules was 52.91 卤22.77 卤92.090.The PEI value of benign nodules was 13.739.93 / 23.270.The difference was statistically significant (P 0.05), the TTP of malignant nodules was 24.75 卤11.47s, the TTP of benign nodules was 18.43 卤7.61s, the difference was not significant (P0.05n.PEI) in the differential diagnosis of benign and malignant pulmonary nodules. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and negative predictive value were 84.00, 83.33, 83.18, 91.30 and 71.42, respectively. Conclusion PEI can be used as a reference index for differentiating benign and malignant solitary pulmonary nodules in multislice spiral CT pulmonary perfusion imaging.
【作者单位】：中国医科大学附属第四医院放射科;
【基金】：辽宁省自然科学基金资助项目(编号:2013021035)
【分类号】：R734.2;R730.44

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