计算机体层摄影术纹理分析诊断肺结节的临床研究探讨

摘要/Abstract

摘要： 目的探讨与分析计算机体层摄影术纹理分析诊断肺结节的临床价值。方法选取2019年2月—2022年5月在江苏省金湖县中医院进行诊治的86例肺结节患者作为研究对象,在86例患者中,病理诊断为恶性结节18例（恶性组）,良性结节68例（良性组）。所有患者都给予常规CT与计算机体层摄影术纹理分析,记录影像学特征并定量纹理参数。结果所有患者图像均能显示4~6级分支,恶性组的CT图像质量评分与良性组比较,差异无统计学意义（P>0.05）。恶性组的分叶征、空泡征、胸膜凹陷征、支气管充气征等占比为88.89%、77.78%、72.22%、83.33%,显著高于良性组的32.35%、33.82%、27.94%、32.35%,差异有统计学意义（P<0.05）。恶性组的肺动脉主干、肺叶动脉、肺段动脉与肺亚段动脉CT值与良性组相比都显著提高,差异有统计学意义（P<0.05）。恶性组的计算机体层摄影纹理分析相关参数——熵值、偏度、最大值与良性组相比都显著提高,差异有统计学意义（P<0.05）。在86例患者中,计算机体层摄影术纹理分析诊断为恶性结节17例,良性结节69例,为此计算机体层摄影术纹理分析诊断肺结节的敏感度与特异度为88.89%（16/18）和98.52%（67/68）。结论计算机体层摄影术纹理在肺结节的应用能够提供肉眼无法观察的纹理特征,可定量评估肺结节,诊断肺结节良恶性具有很好的敏感度与特异度。

关键词: 计算机体层摄影术纹理分析, 肺结节, 支气管充气征, CT值, 熵值, 偏度

Abstract: Objective To investigate and analyze the clinical value of computed tomography texture analysis for the diagnosis of pulmonary nodules. Methods A total of 86 cases with pulmonary nodules who were underwent consultation at Jinhu County Hospital of Traditional Chinese Medicine from February 2019 to May 2022 were selected for the study, and 18 nodules were pathologically diagnosed as malignant nodules (malignant group), while 68 nodules as benign nodules (benign group). All patients were given conventional CT with computed tomography texture analysis to record imaging features and quantify texture parameters. Results All patients' images showed grade 4-6 branches, and there was no significant difference in the CT image quality score in the malignant group compared with the benign group (P>0.05). The percentages of lobar, vacuolar, pleural depression, and bronchial inflation signs in the malignant group were 88.89%, 77.78%, 72.22%, and 83.33%, which were significantly higher than those in the benign group, which were 32.35%, 33.82%, 27.94%, and 32.35% (P<0.05). The CT values of main pulmonary artery, lobar artery, segmental artery and subsegmental artery were significantly higher in the malignant group compared with the benign group (P<0.05). The parameters associated with computed tomographic texture analysis-entropy, skewness, and maximum value-were significantly higher in the malignant group compared with the benign group (P<0.05). Among 86 patients, computed tomography texture analysis diagnosed malignant nodules in 17 cases and benign nodules in 69 cases, for which the sensitivity and specificity of computed tomography texture analysis for the diagnosis of pulmonary nodules were 88.89% (16/18) and 98.52% (67/68). Conclusion The application of computed tomography texture in pulmonary nodules can provide texture features that cannot be observed by the naked eye, allowing quantitative assessment of pulmonary nodules, with good sensitivity and specificity in the diagnosis of benign and malignant pulmonary nodules.

Key words: computed tomography texture analysis, pulmonary nodules, bronchial inflation sign, CT values, entropy values, skewness

中图分类号:

R563

耿加宏, 万娟, 周超. 计算机体层摄影术纹理分析诊断肺结节的临床研究探讨[J]. 中华养生保健, 2024, 42(8): 167-170.

GENG Jia-hong, WAN Jan, ZHOU Chao. A Clinical Study on the Diagnosis of Pulmonary Nodules by Texture Analysis with Computed Tomography[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(8): 167-170.

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