摘要
目的 探讨多层螺旋CT(MSCT)增强扫描在肠癌肺转移与原发性肺癌鉴别诊断中的临床价值.方法 回顾性分析天津市北辰医院收治并行MSCT检查的肠癌肺转移患者(转移组,n=24)和原发性肺癌患者(原发组,n=36)的影像学资料,收集肺部占位性病变的CT值及形态学特征,并以术后病理诊断为金标准,采用ROC曲线评估MSCT增强扫描在肠癌肺转移与原发性肺癌鉴别诊断中的价值.结果 转移组患者24例,平均年龄(68.4±12.1)岁,33个病灶纳入分析,其中15个病灶位于左肺,18个病灶位于右肺,病灶大小为(2.3±1.2)cm;原发组患者36例,平均年龄(66.3±14.2)岁,36个病灶纳入分析,其中16个病灶位于左肺,20个病灶位于右肺,病灶大小为(3.6±1.8)cm.转移组病灶直径显著低于原发组,且差异有统计学意义(P<0.05);转移组33个病灶增强后CT值为(49.2±13.5)HU,显著低于原发组(66.4±18.3)HU,且差异有统计学意义(P<0.05).以病灶大小为参考,鉴别诊断肺转移和原发病灶的敏感性为71.6%(95%CI:54.8%-84.2%),特异性为72.3%(55.8%-84.9%),ROC曲线下面积为0.78(95%CI:0.64-0.86);以CT值为参考鉴别诊断肺转移和原发病灶的敏感性为73.8%(95%CI:57.5%-87.5%),特异性为73.6%(95%CI:56.6%-87.8%),ROC曲线下面积为0.74(95%CI:0.62-0.86).结论 MSCT检查病灶直径大小和CT值可用于肠癌肺转移与原发性肺癌的鉴别诊断.
Objective To explore the clinical value of multi-slice spiral CT(MSCT)enhanced scanning in the differential diagnosis of colorectal cancer lung metastasis and primary lung cancer.Methods A retrospective analysis was conducted on the imaging data of colon cancer lung metastasis(n=24)and primary lung cancer(n=36)admitted to our hospital for concurrent MSCT examination.CT values and morphological features of lung space occupying lesions were collected,and postoperative pathological diagnosis was used as the gold standard.The ROC curve was used to evaluate the value of MSCT enhanced scanning in the differential diagnosis of colon cancer lung metastasis and primary lung cancer.Results The average age of 24 patients in the metastasis group was(68.4±12.1)years old,with 33 lesions included in the analysis.Among them,15 lesions were located in the left lung and 18 lesions were located in the right lung.with a lesion size of(2.3±1.2)cm;there were 36 patients in the primary group,with an average age of(66.3±14.2)years.36 lesions were included in the analysis,of which 16 were located in the left lung and 20 were located in the right lung,with a lesion size of(3.6±1.8)cm.The diameter of the lesion in the metastasis group was significantly lower than that in the primary group,and the difference was statistically significant(P<0.05);the enhanced CT values of 33 lesions in the metastatic group were(49.2±13.5)HU,significantly lower than those in the primary group(66.4±18.3)HU,and the difference was statistically significant(P<0.05).Taking the size of the lesion as a reference.the sensitivity for distinguishing lung metastasis from primary lesion was 71.6%(95%CI:54.8%-84.2%),the specificity was 72.3%(55.8%-84.9%),and the area under the ROC curve was 0.78(95%CI:0.64-0.86):the sensitivity and specificity of distinguishing lung metastasis and primary lesion based on CT values were 73.8%(95%CI:57.5%-87.5%)and 73.6%(95%CI:56.6%-87.8%),respectively.The area under the ROC curve was 0.74(95%CI:0.62-0.86).Conclusion MSCT examination of lesion diameter and CT value can be used for the dfferential diagnosis of colorectal cancer lung metastasis and primary lung cancer.
作者
杜石伟
Du Shiwei(Tianjin Beichen Hospital,Tianjin 300400,China)
出处
《首都食品与医药》
2024年第17期92-95,共4页
Capital Food Medicine
关键词
多层螺旋CT
肺癌
肺转移癌
敏感性
ROC曲线
Multi slice spiral CT
Lung cancer
Lung metastatic cancer
Sensitivity:ROC curve
