高分辨率CT靶向多期增强扫描联合三维重建技术评估肺结节良恶性的研究OA
Evaluation of benign and malignant pulmonary nodules by high resolution CT targeted multi-phase enhanced scanning combined with 3D reconstruction technology
目的:探讨高分辨率计算机断层扫描(HRCT)靶向多期增强扫描联合三维重建技术在肺结节良恶性诊断中的应用价值.方法:选取2021 年6 月—2024 年 6 月连云港第二人民医院收治的 142 例肺结节患者,以病理检查结果为金标准,分为良性组(n=73)与恶性组(n=69),比较两组影像学特征、CT纹理参数,并比较HRCT靶向多期增强扫描联合三维重建技术诊断肺结节良恶性的效能.结果:恶性组淋巴结增大、病灶边缘毛刺/分叶、内部结构不均匀、血管受累及强化不均匀患者占比高于良性组,差异有统计学意义(P<0.05).恶性组中灰度范围、和熵、三维空间内最大直径、灰度共生矩阵熵值、熵、熵和、熵差均高于良性组,能量、短期低灰度游程强度、球状度均低于良性组,差异均具有统计学意义(P<0.05).HRCT靶向多期增强扫描联合三维重建技术诊断恶性肺结节65例、良性77例,与金标准检测结果的一致性好(Kappa=0.802).多因素分析结果显示,淋巴结增大、病灶边缘毛刺/分叶、内部结构不均匀、血管受累、强化不均匀、灰度范围、三维空间内最大直径、灰度共生矩阵熵值、熵是恶性肺结节的独立危险因素,能量、短期低灰度游程强度是其独立保护因素(P<0.05).5 折交叉验证中,联合指标诊断恶性肺结节的受试者工作特征(ROC)曲线的曲线下面积(AUC)为 0.904,F1 值为0.874.HRCT靶向多期增强扫描联合三维重建技术鉴别肺结节良恶性的敏感度、特异度、阳性预测值、阴性预测值和准确度分别为 0.870、0.932、0.923、0.883、0.901.结论:HRCT靶向多期增强扫描联合三维重建技术对肺结节良恶性具有重要诊断价值,可有效提高诊断准确率.
Objective:To investigate the application value of high-resolution computed tomography(HRCT)targeted multi-phase enhanced scanning combined with 3D reconstruction technology in the diagnosis of benign and malignant pulmonary nodules.Methods:A total of 142 patients with pulmonary nodules admitted to the Second People's Hospital of Lianyungang City from June 2021 to June 2024 were selected and divided into benign group(n=73)and malignant group(n=69)with patho-logical examination results as the gold standard.Imaging features and CT texture analysis results were compared between the two groups.The efficacy of HRCT targeted multi-phase enhanced scanning combined with 3D reconstruction technology in the diagnosis of benign and malignant pulmonary nodules was compared.Results:The proportions of patients with lymph node en-largement,spiculation/lobulation at the lesion edge,uneven internal structure,vascular involvement and uneven enhancement in the malignant group were higher than those in the benign group,and the difference was statistically significant(P<0.05).In the malignant group,grayrange(Ramge),haraentropy,maximum 3D diameter,gray-level co-occurrence matrix(GLCM)entropy,en-tropy,entropy sum,and entropy difference were all higher than those in the benign group.Energy,Short run low grey level emphasis(SRLGLE),and sphericity were lower than those in the benign group,the differences were statistically significant(P<0.05).There were 65 malignant cases and 77 benign cases diagnosed by HRCT targeted multi-phase enhanced scanning com-bined with 3D reconstruction technology,which was in good agreement with the gold standard detection results(Kappa=0.802).The results of multivariate analysis showed that lymph node enlargement,burrs/lobulation at the lesion edge,uneven internal structure,vascular involvement,uneven enhancement,Ramge,maximum 3D diameter,GLCM entropy and entropy were inde-pendent risk factors for the malignancy of pulmonary nodules,while energy and SRLGLE were independent protective factors(P<0.05).In the 5-fold cross-validation,the average area under the receiver operating characteristic(ROC)curve of the com-bined indicators for diagnosing malignant pulmonary nodules was 0.904,and the F1 value was 0.874.The sensitivity,speci-ficity,positive predictive value,negative predictive value and accuracy of HRCT targeted multi-phase enhanced scanning combined with 3D reconstruction technology in differentiating benign and malignant pulmonary nodules were 0.870,0.932,0.923,0.883 and 0.901 respectively.Conclusion:HRCT targeted multi-phase enhanced scanning combined with 3D recon-struction technology has important diagnostic value in the diagnosis of benign and malignant pulmonary nodules,and can ef-fectively improve the diagnostic accuracy.
赵妍;耿磊;李桂芬
连云港市第二人民医院放射科,江苏 连云港 222000连云港市第二人民医院放射科,江苏 连云港 222000连云港市第二人民医院放射科,江苏 连云港 222000
医药卫生
肺肿瘤体层摄影术,X线计算机
Lung NeoplasmsTomography,X-Ray Computed
《中国临床医学影像杂志》 2026 (3)
186-190,5
连云港市科技局重点研发计划项目(SF2311).
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