CT全瘤灌注參數(shù)在對(duì)肺癌與肺良性病變鑒別診斷中的應(yīng)用
發(fā)布時(shí)間:2018-03-23 14:15
本文選題:肺癌 切入點(diǎn):肺良性病變 出處:《廣東醫(yī)學(xué)》2017年S1期
【摘要】:目的探討多層螺旋CT全瘤灌注參數(shù)對(duì)肺癌及肺良性病變鑒別診斷的應(yīng)用價(jià)值。方法對(duì)初診61例肺內(nèi)單發(fā)直徑2 cm的腫塊性病變進(jìn)行前瞻性CTPI,通過(guò)CT灌注后處理得出血流量(BF)、血容積(BV)、平均通過(guò)時(shí)間(MTT)、透析度(PMB)4個(gè)灌注參數(shù),并使用SPSS 22.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果 (1)肺癌病灶與肺良性病變灌注參數(shù)比較,BV、MTT、PMB的差異有統(tǒng)計(jì)學(xué)意義(P0.05);BF差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(2)肺癌與肺良性病變CT全瘤灌注參數(shù)(BF、BV、MTT、PMB)ROC曲線下面積分別為0.596、0.806、0.705、0.961。BF的最大約登指數(shù)為0.324,此時(shí)BF值49.13 m L/(100 m L·min),敏感度為80.00%,特異度為52.40%,陽(yáng)性預(yù)測(cè)值為75.34%,陰性預(yù)測(cè)值為59.03%。BV的最大約登指數(shù)為0.510,此時(shí)為BV值6.67 m L/100 m L,敏感度為70%,特異度為81.00%,陽(yáng)性預(yù)測(cè)值為87.17%,陰性預(yù)測(cè)值為60.57%。MTT的最大約登指數(shù)為0.499,此時(shí)MTT值3.83 s,敏感度為97.50%,特異度為52.40%,陽(yáng)性預(yù)測(cè)值為78.83%,陰性預(yù)測(cè)值為92.05%。PMB的最大約登指數(shù)指數(shù)為0.830,此時(shí)PMB值7.28 m L/(100 m L·min),敏感度為92.50%,特異度為90.50%,陽(yáng)性預(yù)測(cè)值為94.65%,陰性預(yù)測(cè)值為86.91%。結(jié)論 CT全瘤灌注參數(shù)對(duì)肺癌和肺良性病變的鑒別診斷有較大的幫助。4個(gè)灌注參數(shù)中,以BV及PMB的鑒別效能較好且以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.
【作者單位】: 廣州醫(yī)科大學(xué)附屬第一醫(yī)院放射科;
【基金】:廣東省科技計(jì)劃項(xiàng)目(編號(hào):2014A020212608)
【分類號(hào)】:R563;R730.44;R734.2
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