Application Value of Multi-slice Spiral CT Three-phase Enhancement Scan in the Preoperative Diagnosis of Mediastinal Lymph Node Metastasis in Patients With Non-small Cell Lung Cancer
Objective To explore the evaluation value of multi-slice spiral CT(MSCT)three-phase enhancement scan for mediastinal lymph node metastasis(MLNM)in non-small cell lung cancer(NSCLC).Methods A retrospective analysis was performed on the clinical data of 80 patients with NSCLC.All underwent three-phase enhancement scan before surgery.Taking postoperative pathological results as the golden standard,the diagnostic efficiency of MSCT three-phase enhancement scan for ML-NM was evaluated by Kappa consistency test.Results Postoperative pathology showed that in the 80 NSCLC patients,there were 31 cases at stage NO,24 cases at stage N1 and 25 cases at stage N2,including 25 cases(31.25％)with MLNM.MSCT showed that there were 34 cases at stage NO,24 cases at stage N1 and 22 cases at stage N2.The consistency between preoperative MSCT and postoperative pathology in the diagnosis of N staging was general(Kappa=0.735).Among the 25 patients with MLNM,pre-operative MSCT showed that there were 19 confirmed cases,consistency between preoperative MSCT and postoperative pathology in the diagnosis of MLNM was general(Kappa=0.531).The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of MSCT were 76.00％,80.00％,78.75％,63.33％and 88.00％,respectively.There were signifi-cant differences in MLNM rate among NSCLC patients with different tumor diameters,pleural depression,different enlarged lymph node sites,involvement of large pulmonary veins and lymph node diameters(P＜0.05).Conclusion Preoperative MSCT three-phase enhancement scan has certain diagnostic accuracy for MLNM in NSCLC patients,and its combination with size of primary lesions,pleural depression,sites of enlarged lymph nodes and involvement of pulmonary veins can provide important reference for lymph node dissection.
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