64排螺旋CT高级肺分析软件对单发肺小结节的诊断价值.docVIP

64排螺旋CT高级肺分析软件对单发肺小结节的诊断价值 作者：肖叶玉 徐志锋 吴仁华 洪璧楷 张远芳 郑文斌 【摘要】 目的 通过比较64排螺旋CT( 64-muti detector spiral CT, MSCT)高级肺分析软件(Advanced Lung Analysis software,ALA)对单发肺小结节三维体积测量、三维形态特征与传统三平面重建二维径线测量、二维形态特征结果，了解高级肺分析软件对单发肺小结节的诊断价值。 方法 选取64排螺旋CT胸部扫描发现单发肺小结节(直径≤2cm)的病人15例(女6例,男9例),全部病例经临床与病理确诊，由两位副主任医师按双盲法采用GE AW4.3工作站的Advantage-ALA进行肺结节自动分离,记录其三维体积数值与三维形态特征;15天后，用三平面重建分析病灶二维最大测量径线、二维形态特征。采用双变量相关分析评价测试者间一致性;同时采用配对计数资料的检验评价两种分析方法按观察到的良、恶性影像特征得出的影像诊断结果的准确性，Plt;0.05认为差异有显著性意义。结果 15例单发肺小结节经临床与病理确诊为周围型肺癌6例，转移瘤5例，结核球2例，慢性非结核性炎性假瘤1例，肺血管断面1例。两测试者体积测量结果一致性(r为1.000)比直径测量结果的一致性要好(r=0.609),P=0.016，差别具有统计学意义;ALA分析所得影像特征准确性较高，=17.344，P=0.002，Kappa=0.690，两者符合率为中高度(0.4～0.75)，P =0.000，差异有统计学意义。结论 单发肺小结节64-MSCT ALA三维体积测量比传统二维测量方法更具准确性;三维形态特征较二维形态特征更具准确性;ALA软件诊断单发肺小结节具有较高的临床应用价值。 【关键词】 单发肺结节;64排螺旋CT(64-MDCT);高级肺分析软件(ALA) [Abstract] Objective To evaluate the 64-MSCT with Advantage Advanced Lung Analysis (ALA) software in the diagnosis of small solitary pulmonary nodules. Methods Fifteen patients (6 women, 9 men) with small solitary pulmonary nodules(SPN) who underwent the examination with 64 - detector spiral CT (Lightspeed VCT, GE) were included, the diameter of nodules were less than 2cm. CT images were analyzed by same two radiologists respectively. The volumes of pulmonary nodules were measured and the morphologies were described separately with ALA software. Then, two-dimensional maximum diameter measurements and morphologies were also acquired in the GE AW4.3 workstation 15 days later. Bivariate method and the Spearman correlation coefficients were used to test the variability between three dimensional(3D) measurements and two dimensional(2D) ones; Paired-Samples T Test were used to test the accurate rate of diagnosis that was analyzed by 3D and 2D. Results Fifteen small SPN were histologically or clinically proved: peripheral pulmonary cancer 6 cases, metastatic tumors 5 cases, tuberculomas 2 cases, inflammatory pseudotumor 1 case, pulmonary vascular section