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目的 探讨肺部结节CT靶扫描的应用价值。材料与方法 筛选同时具有常规 10mm层厚和靶扫描的CT资料共 70例 ,诊断证实途径包括手术切除、经皮肺穿刺、痰脱落细胞学、抗炎治疗或随访 2年以上。结节大小为 0 .5～ 3 .0cm ,平均 2 .2cm。CT常规扫描采用 10mm层厚 ,靶扫描采用小FOV( 14～ 2 0cm) ,包括一侧肺和纵隔 ,层厚 2～ 5mm ,pitch =1～ 2 ,重建时重叠 40 %～ 67%。 3 6例作了三维重建 (表面遮盖显示法 ,SSD)。诊断依据可靠程度分为四等级 :明确诊断、可能性大、可能、无诊断倾向或未诊断 ,分别对常规扫描和靶扫描进行回顾性评价并对比。统计检验采用参照单位分析法和卡方检验。结果 70例扫描中经靶扫描作出明确诊断者 3 6例 ( 5 1.4% ) ,可能性大者 2 7例 ( 3 8.6% ) ,可能者 4例 ( 5 .7% ) ;前三级诊断准确率为 95 .7% ( 67/ 70 ) ,显著高于常规扫描( 68.6% ,48/ 70 ;χ2 =8.64 ,P <0 .0 1) ;明确诊断比率为 5 1.4% ( 3 6/ 70 ) ,显著高于常规扫描 ( 8.6% ,6/ 70 ;χ2 =3 3 .77,P <0 .0 1)。靶扫描诊断可靠性明显优于常规扫描 (前者R值为 95 % ,可信区间为 0 .2 79～ 0 .417,后者为 0 .10 8～ 0 .2 46,两者无重叠 ,P <0 .0 5 )。结论 螺旋CT靶扫描有助于肺部结节的鉴别诊断 ,是肺部结节检查的有?
Objective To investigate the value of CT scanning in pulmonary nodules. MATERIALS AND METHODS SCREENING There were 70 cases of CT data with conventional 10 mm layer thickness and target scan. The pathways confirmed by the diagnosis included surgical resection, percutaneous pulmonary puncture, sputum cytology, anti-inflammatory treatment or follow-up for more than 2 years. Nodule size of 0.5 ~ 3 .0cm, an average of 2.2cm. Conventional CT scan with 10mm layer thickness, the target scan using a small FOV (14 ~ 20cm), including one side of the lung and mediastinum, layer thickness 2 ~ 5mm, pitch = 1 ~ 2, reconstruction overlap 40% to 67%. Thirty-six cases underwent three-dimensional reconstruction (surface coverage display method, SSD). The diagnosis is divided into four grades based on the degree of reliability: a clear diagnosis, the possibility of large, possible, no diagnostic tendency or not diagnosed, conventional scanning and target scanning were retrospectively evaluated and compared. Statistical tests using the reference unit analysis and chi-square test. Results Among the 70 cases, 36 cases (5. 14%) were confirmed by target scanning, 27 cases (36.6%) were most likely, and 4 cases were likely (5.7%). The accuracy of the first three stages of diagnosis The rate was 95.7% (67/70), which was significantly higher than that of the routine scan (68.6%, 48/70; χ2 = 8.64, P <0.01) , Which was significantly higher than that of routine scanning (8.6%, 6/70; χ2 = 33.77, P <0.01). The reliability of the target scan was significantly better than that of the conventional scan (the former R value was 95%, the confidence interval was 0.79 ~ 0.177, the latter was 0.108 ~ 0.266, the two had no overlap, P <0 .0 5). Conclusion Helical CT scan is helpful to the differential diagnosis of pulmonary nodules.