Value of Thin-section CT Signs and Quantitative Parameters in the Diagnosis of Pulmonary Nodules
陶瑜 1陆凯 1李倩余2
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作者信息
1. 南京医科大学附属常州第二人民医院放射科,江苏常州 213164
2. 南京医科大学附属常州第二人民医院导管室,江苏常州 213164
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摘要
目的 探讨薄层CT征象及定量参数对孤立性肺结节(solitary pulmonary nodule,SPN)的诊断价值.方法 回顾性选取2022年1月—2023年9月在南京医科大学附属常州第二人民医院接受术前薄层CT扫描检查的126例SPN患者的临床资料,根据病理检测结果分为良性组和恶性组.对比两组患者的临床指标,分析薄层CT征象及定量参数差异,采用受试者操作特征(receiver operating char-acteristic,ROC)曲线分析各项指标对SPN性质的诊断价值.结果 经病理检测,126例SPN患者中恶性37例(29.37%),良性89例(70.63%).恶性组包括肺腺癌15例,细支气管肺泡癌10例,鳞状细胞癌12例;良性组包括肺结核26例,炎性假瘤33例,肺错构瘤20例,血管滤泡性淋巴结增生10例.恶性组的年龄高于良性组,差异有统计学意义(P<0.05).在CT扫描中,恶性组和良性组的结节位置、分叶征、毛刺征、血管集束征、结节直径和定量参数(分叶征象、毛刺数)比较,差异有统计学意义(P均<0.05).ROC曲线预测模型中,薄层CT征象及定量参数联合预测的曲线下面积(area under the curve,AUC)为0.956,95%CI为0.924～0.988,约登指数为0.789,灵敏度为94.60%,特异度为84.30%.结论 薄层CT征象及定量参数对恶性SPN具有较高预测价值.
Abstract
Objective To explore the diagnostic value of thin-section CT signs and quantitative parameters for solitary pulmonary nodule(SPN).Methods Clinical data of 126 SPN patients who underwent preoperative thin-section CT scans at Changzhou Second People's Hospital Affiliated to Nanjing Medical University from January 2022 to September 2023 were retrospectively selected and were divided into benign group and malig-nant group according to the pathological examination results.The clinical indicators of the two groups of pa-tients were compared,the differences in thin-section CT signs and quantitative parameters were analyzed,and the receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of each indicator for the nature of SPN.Results After pathological examination,37 cases(29.37%)of 126 cases SPN patients were malignant and 89 cases(70.63%)were benign.The malignant group included 15 cases of lung adenocarcinoma,10 cases of bronchioloalveolar carcinoma,and 12 cases of squamous cell carcinoma.The benign group included 26 cases of pulmonary tuberculosis,33 cases of inflammatory pseudotumor,20 cases of pulmonary hamartoma,and 10 cases of angiofollicular lymph node hyperplasia.The age of the malignant group was higher than that of the benign group,and the difference was statistically significant(P<0.05).In CT scans,the nodule location,lobulation sign,spiculation sign,vessel clustering sign,nodule diameter and quantitative parameters(lobulation sign,number of spiculations)were compared between the malignant group and the benign group,and the differ-ences were statistically significant(all P<0.05).In the ROC prediction model,the area under the curve(AUC)was 0.956,95%CI:0.924-0.988,Youden index was 0.789,sensitivity was 94.60%,and specificity was 84.30%predicted by thin-section CT signs and quantitative parameters.Conclusion Thin-section CT signs and quanti-tative parameters have high predictive value for malignant SPN.
关键词
CT/征象/肺结节/结节性质/诊断
Key words
CT/Signs/Pulmonary nodules/Nature of nodules/Diagnosis
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