| 孔芳,段艳华,宋学林,王锡明.高分辨率CT鉴别诊断良、恶性实性孤立性肺结节[J].中国医学影像技术,2021,37(8):1168~1172 |
| 高分辨率CT鉴别诊断良、恶性实性孤立性肺结节 |
| High-resolution CT for differential diagnosis of benign and malignant solid solitary pulmonary nodules |
| 投稿时间：2020-08-13 修订日期：2021-05-20 |
| DOI：10.13929/j.issn.1003-3289.2021.08.012 |
| 中文关键词: 肺肿瘤 诊断,鉴别 体层摄影术,X线计算机 |
| 英文关键词:lung neoplasms diagnosis, differential tomography, X-ray computed |
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| 中文摘要: |
| 目的 观察实性孤立性肺结节（SPN）高分辨率CT（HRCT）表现。方法 回顾性分析235例HRCT检出的实性SPN患者，其中54例良性（良性组），181例恶性（恶性组）。比较组间HRCT表现差异，包括分叶征、毛刺征、空洞征、空泡征、钙化、远端穿行血管、胸膜牵拉征、贴近胸膜及牵拉性肺气肿；评估差异有统计学意义的征象鉴别良、恶性SPN的效能，分析良、恶性SPN的影响因素。结果 组间毛刺征、胸膜牵拉征、钙化征象差异均无统计学意义（P均>0.05），其余征象差异均有统计学意义（P均<0.05）。血管集束征鉴别良、恶性SPN的效能最高，敏感度达92.30%。回归分析显示血管集束征是恶性SPN的危险征象，牵拉性肺气肿为其保护因素（P均<0.05）。结论 良、恶性SPN的HRCT表现存在差异，对鉴别诊断具有一定价值。 |
| 英文摘要: |
| Objective To observe high-resolution CT (HRCT) manifestations of solid solitary pulmonary nodules (SPN). Methods Data of 235 patients with solid SPN detected with HRCT were retrospectively analyzed, including 54 patients with benign (benign group) and 181 with malignant lesions (malignant group).HRCT manifestations were compared between groups, including lobulation sign, burr sign, cavity sign, vacuole sign, calcification, distal vessels of the lesion, pleural traction sign, close to the pleura and tractive emphysema. The efficacies of HRCT manifestations being statistically different between groups for differentiating benign and malignant SPN were evaluated, and the impact factors of benign and malignant SPN were analyzed. Results There was no statistical difference of the rate of burr sign, pleural traction sign nor calcification (all P>0.05), while the rates of the rest signs were significantly different between groups (all P<0.05). Vascular cluster sign was the most effective in differentiating benign and malignant SNP, with a sensitivity of 92.30%. Regression analysis showed that vascular cluster sign was risk factor for malignant SNP, while tractive emphysema behaved as a protective factor (both P<0.05). Conclusion HRCT manifestations of benign and malignant SPN were somehow different, which were valuable for differential diagnosis to some extent. |
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