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目的:分析数字X线摄片(DR)、CT及其联合应用对周围型肺癌的诊断价值。方法:选择该院2012年2月~2016年3月收治早期周围型肺癌患者90例为研究对象,分别进行数字化X线摄影和CT检查,以手术切除或病理结果为最终诊断的金标准,计算两种检查方法及其联合对早期诊断周围型肺癌的敏感度、特异度和准确率阳性预测值以及阴性预测值。结果:胸部DR检出空泡征者7例(7.8%),分叶征47例(52.2%),边缘有细小毛刺征36例(40%),胸膜凹陷征9例(10%);CT见病变边缘分叶征71例(78.8%),长短毛刺征57例(63.3%),空洞征27例(30%),胸膜凹陷征32例(35.6%)。DR诊断周围型肺癌的敏感性、特异性及准确性分别为85%、81%、85.6%,而CT则为90%,87.6%,90.5%,均高于DR。DR与CT两者联合诊断周围型肺癌的敏感性为98.4%,显著高于DR(85%)和CT(90%)。结论:在早期周围型肺癌的影像学诊断中,CT的临床价值显著优于DR,而两者联合诊断的临床价值明显优于单独检测。
Objective: To analyze the diagnostic value of digital radiography (DR), CT and their combination in peripheral lung cancer. Methods: Totally 90 patients with early-stage peripheral lung cancer who were treated in our hospital from February 2012 to March 2016 were enrolled in the study. Digital radiography and CT were performed respectively. The final gold standard was calculated by surgical resection or pathological results Sensitivity, specificity and accuracy of the two methods and their combination of early detection of peripheral lung cancer, positive predictive value and negative predictive value. Results: There were 7 cases (7.8%) with vacuolar sign in chest, 47 cases (52.2%) with lobulation, 36 cases (40%) with small burr on the edge and 9 cases (10%) with pleural indentation. CT 71 cases (78.8%) showed lobular etiology of lesion, 57 cases (63.3%) were long and short burr, 27 cases (30%) had hollow sign and 32 cases (35.6%) of pleural indentation. The sensitivity, specificity and accuracy of DR in diagnosing peripheral lung cancer were 85%, 81% and 85.6% respectively, while those in CT were 90%, 87.6% and 90.5%, respectively. The sensitivity of both DR and CT in diagnosing peripheral lung cancer was 98.4%, significantly higher than that of DR (85%) and CT (90%). Conclusion: The clinical value of CT in early diagnosis of peripheral lung cancer is significantly better than that of DR, and the clinical value of combined diagnosis of the two is better than that of single diagnosis.