Clinical value of CT target reconstruction combined with MRI scanning in the diagnosis of solitary pulmonary nodules early and mid-term peripheral lung cancer
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摘要:
目的研究CT靶重建联合MRI扫描诊断孤立性肺结节中早期周围型肺癌的临床价值。 方法选取2017年8月~2020年8月我院收治的118例孤立性肺结节周围型肺癌患者，所有患者均接受CT靶重建以及MRI扫描进行分期检查，分析两种检查方式的病理特征，最终以术后病理学检查为金标准，分析两种检查结果的准确率以及诊断价值。 结果CT靶重建提示T1期患者38人，T2期患者35人，T3期患者30人，T4期患者15人，早中期患者73人，准确率91.21%；MRI扫描诊断提示T1期患者39人，T2期患者33人，T3期患者32人，T4期患者14人，早中期患者72人，准确率90.00%；CT靶重建联合MRI扫描诊断提示T1期患者42人，T2期患者37人，T3期患者29人，T4期患者10人，早中期患者79人，准确率98.75%。CT靶重建在肿瘤内部空洞特征、周围特征分叶征的检出率高于MRI扫描方式（P < 0.05）；MRI检查对于患者的淋巴结、血管断面、侵润、积液、胸膜凹陷征的检出率高于CT靶重建检查；CT靶重建检查对于患者的病灶钙化检查率高于MRI检查（P < 0.05）。CT靶重建联合MRI扫描对于孤立性肺结节中早期周围型肺癌的特异性和敏感度均高于各项单独检查。 结论CT靶重建联合MRI扫描对孤立性肺结节中早期周围型肺癌的诊断价值较高，特异度和灵敏度都高于各项单独诊断。 Abstract:ObjectiveTo explore the clinical value of CT target reconstruction combined with MRI scan in the diagnosis of solitary pulmonary nodules of early and mid-term peripheral lung cancer. MethodsOne hundred and eighteen patients with solitary pulmonary nodules peripheral lung cancer admitted to our hospital from August 2017 to August 2020 were selected. The patients received CT target reconstruction and MRI scan for staging examinations. The pathological characteristics of the two examination methods were analyzed. Finally, postoperative pathological examination was used as the gold standard to analyze the accuracy and diagnostic value of the two examination results. ResultsCT target reconstruction indicated that there were 38 patients in T1 stage, 35 in T2 stage, 30 in T3 stage, 15 in T4 stage, and 73 early and mid-term patients, with an accuracy rate of 91.21%. MRI scan diagnosis indicated there were 39 in T1 stage, 33 in T2, 32 in T3, 14 in T4, and 72 in early and mid-term, with an accuracy rate of 90.00%. CT target reconstruction combined with MRI scan diagnosis indicated that there were 42 patients in T1, 37 in T2 stage, 29 in T3 stage, 10 in T4 stage, and 79 in early and mid-term, with an accuracy rate of 98.75%. The detection rate of CT target reconstruction of the internal tumor with in the cavity characteristics and the peripheral characteristics of the tumor was significantly higher than that of MRI scanning mode (P < 0.05). The detection rate of MRI examination for patients' lymph nodes, vascular cross-sections, invasion, effusion, and pleural indentation signs was significantly higher than that of CT target reconstruction examination. CT target reconstruction examination had a significantly higher detection rate of lesion calcification for patients than MRI examination (P < 0.05). The specificity and the sensitivity of CT target reconstruction combined with MRI scan for early-stage peripheral lung cancer in solitary pulmonary nodules were higher than those of individual examinations. ConclusionCT target reconstruction combined with MRI scan has a higher diagnostic value for solitary pulmonary nodules of early and mid-term stage peripheral lung cancer. The specificity and sensitivity are higher than those of individual diagnosis. -
Key words:
- CT target reconstruction /
- MRI scan /
- solitary lung nodule /
- peripheral lung cancer /
- clinical value
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表 1 两种检查方式分期诊断结果
Table 1. Results of staging diagnosis by two examination methods
组别 T1 T2 T3 T4 病理检查结果 42 38 28 10 CT靶重建 38 35 30 15 MRI扫描诊断 39 33 32 14 CT靶重建联合MRI扫描诊断 42 37 29 10 
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表 2 两种检查方式内部情况和周围特征性对比
Table 2. Comparison of internal conditions and surrounding characteristics of the two inspection methods
组别 空洞 空泡 细支气管征 分叶征 棘突征 毛刺征 CT靶重建 52 31 30 61 28 35 MRI扫描诊断 28 29 32 31 31 34 χ2 4.41 0.632 1.018 6.353 2.600 1.299 P 0.03 0.426 0.312 0.011 0.106 0.254
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表 3 两种检查结果对周围型肺癌病灶显示情况对比
Table 3. Comparison of two kinds of examination results for peripheral lung cancer lesions
组别 淋巴结 血管断面 侵润 积液 胸膜凹陷征 钙化 CT靶重建 16 19 18 15 15 82 MRI扫描诊断 42 43 45 42 43 35 χ2 6.301 3.954 1.018 4.985 5.436 62.565 P 0.01 0.046 0.312 0.0251 0.019 < 0.001
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表 4 CT靶重建联合MRI扫描对于孤立性肺结节中早期周围型肺癌的诊断价值分析
Table 4. Diagnostic value of CT target reconstruction combined with MRI scan in early peripheral lung cancer of solitary pulmonary nodules
指标 AUC 标准误 P 95%CI 敏感度（%） 特异性（%） CT靶重建 0.880 0.019 < 0.001 0.873~0.916 83.9 92.0 MRI扫描诊断 0.903 0.017 < 0.001 0.870~0.937 87.5 93.2 CT靶重建联合MRI扫描诊断 0.952 0.012 < 0.001 0.928~0.976 93.8 96.6
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