MSCT MPR重建与Lung Care软件对周围型小肺癌边缘征象诊断价值.docVIP

MSCT MPR重建与Lung Care软件对周围型小肺癌边缘征象的诊断价值 　　【摘要】 目的 探讨MSCT MPR重建与Lung Care 软件结节分析对周围型小肺癌边缘征象的诊断价值并进行比较。方法 对56例周围型小肺癌(其中腺癌23例,鳞癌16例,细支气管肺泡癌9例,转移癌8例)患者均行MSCT全肺容积扫描,再经MPR重建及进行Lung Care 软件分析结节边缘征象。结果 MSCT及Lung Care软件结节分析与MPR重建可对周围型肺癌边缘改变做出分析,二者比较在显示深分叶征、胸膜凹陷征、细短毛刺征、血管集束征方面无统计学意义(P0.05),在显示胸膜侧肺部病变方面有统计学意义(P 　　【关键词】MSCT;肺癌; MPR;Lung Care;体层摄影术;X线计算机 　　 　　The value of MSCT MPR reconstruction and Lungcare software for the edge of signs of small peripheral lung cancer diagnosis 　　SHAN Yu qing,WANG Yan bing,ZHANG Shan juan,et al.Department of Radiology,the People’s Hospital of Rizhao,Shandong 276826,China 　　【Abstract】 Objective To investigate and compare the value of MSCT MPR reconstruction and Lung Care software analysis of the nodules for studying on little lung cancer edge sign.Methods 56 patients with small peripheral lung cancer,including 23 cases of adenocarcinoma,16 cases of squamous cell carcinoma,9 cases of bronchioloalveolar carcinoma,8 cases of metastatic carcinoma,had been scaned by MSCT with both full line lung volume,and then by MPR reconstruction and Lung Care software analysis of the edge of signs of nodules.Results MSCT MPR reconstruction and Lung Care Software nodule analysis can be signs of peripheral lung edge of an analysis.Compare the two shows of deep lobulation,pleural indentation,small short burr sign,vascular convergence sign in no significant(P0.05),but pleural side of the lungs in the display area was statistically significant(P 　　CT征象显示对比(n=56,例,%) 　　MPRLung Care卡方检验P值 　　深分叶征51(91.1)51(91.1)0.900 　　胸膜凹陷征41(73.2)35(62.5)0.250 　　胸细短毛刺征53(94.6)51(91.1)0.750 　　血管集束征36(64.2)37(66.1)0.900 　　胸膜侧肺部病变28(50)3(5.2)3 cm的结节则没有显示优势;同时显示范围偏小并对渗出性病变无显示优势,故对于周围周围肺内渗出性病变显示不佳。这些缺点在显示较大病灶和显示胸膜侧肺内病变较MPR重建明显差的多。 　　总之,周围肺占位中的边缘征象可以提供较多的参考信息,我们可通过多层螺旋CT的不同成像方法完成对其良恶性诊断意义的判断。但同时我们也必须紧密结合病灶内部、肺内及周围器官所提供的有益征象。将该征象与肺外周结节的毛刺、支气管血管聚集征等其他主要征象以及临床资料进行综合分析,可显著提高肺外周结节的CT诊断准确率。尤其是MPR及Lung Care软件分析的研究可能会提供更具有价值的信息。 　　图1~3 同一病例,男性,45岁,穿刺活检为右肺上叶炎性假瘤 　　图1 横断扫描