摘要
目的比较数字化X线摄影(DR)与低剂量计算机断层扫描(LD-CT)在早期肺癌诊断中的效能。方法回顾性分析73例肺癌疑似患者的胸部DR和LD-CT资料。以手术和组织病理活检结果为"金标准",双盲法分析统计两种诊断方式在早期肺癌筛查中的诊断效能。结果两种诊断方式对不同边缘形态病灶的检出率比较,差异均具有统计学意义(P<0.05)。73例患者经手术和组织病理活检确诊为肺癌者57例,DR、LD-CT对肺癌的阳性检出率分别为52.05%、72.60%。LD-CT诊断早期肺癌的灵敏度和诊断符合率明显高于DR(P<0.05),尤其是中央型肺癌病灶。DR对中央型肺癌病灶的诊断结果与"金标准"结果一致性一般(Kappa系数为0.386),对周围型肺癌病灶的诊断结果与"金标准"结果一致性中等(Kappa系数为0.573)。LD-CT对中央型肺癌病灶的诊断结果与"金标准"结果完全一致(Kappa系数为0.973),对周围型肺癌病灶的诊断结果与"金标准"结果具有高度一致性(Kappa系数为0.750)。结论在早期肺癌影像学诊断中,LD-CT的诊断效能优于DR,适合在大规模疑似肺部病变筛查中使用。
Objective To compare the effectiveness of digital radiography(DR)and low-dose computed tomography(LD-CT)in the diagnosis of early lung cancer.Methods The chest DR and LD-CT data of 73 patients suspected lung cancer were retrospectively analyzed,the results of surgery and histopathological biopsy were taken as the"gold standard",and the double-blind analysis was used to analyze the diagnostic results of the two diagnostic methods in early lung cancer screening.Results There were significant differences in the detection rates of lesions with different edge morphology between the two diagnostic methods(P<0.05).Fifty-seven patients of 73 patients were diagnosed as lung cancer by operation and histopathological biopsy,the positive detection rates of DR and LD-CT in lung cancer were52.05%and 72.60%respectively.The sensitivity and coincidence rate of LD-CT in the diagnosis of early lung cancer were significantly higher than those of DR(P<0.05),especially for central lung cancer.The diagnostic results of DR for central lung cancer lesions were generally consistent with the"gold standard"results(Kappa coefficient was 0.386),and the diagnostic results of DR for peripheral lung cancer lesions were moderately consistent with the"gold standard"(Kappa coefficient was 0.573).The diagnosis results of LD-CT for central lung cancer lesions were completely consistent with the"gold standard"(Kappa coefficient was 0.973),and the diagnosis results of LD-CT for peripheral lung cancer lesions were highly consistent with the"gold standard"(Kappa coefficient was 0.750).Conclusion Compared with DR,LD-CT has better diagnostic efficiency in the imaging diagnosis of early lung cancer,which is suitable for large-scale screening of suspected lung lesions.
作者
王刚
王勇
WANG Gang;WANG Yong(Radiology Department,Yangling Demonstration Zone Hospital,Xianyang 712100;Radiology Department,Weinan Central Hospital,Weinan 714000,China)
出处
《临床医学研究与实践》
2020年第26期137-139,共3页
Clinical Research and Practice
