| 摘要: |
| 目的 探索多平面重建（MPR）联合容积再现重建（VR）对肺小结节（直径≤1.0cm）的早期诊断价值。方法 回顾性分析159例患者经手术病理确诊肺小结节的术前CT薄层扫描（TSCT）、MPR和VR图像表现，采用ROC曲线比较分析MPR联合VR与TSCT诊断肺小结节的灵敏度、特异度和正确率，并对阅片医师与病理金标准的一致性及阅片医师之间的一致性进行分析评价。结果在毛刺征、分叶征、血管集束征以及胸膜牵拉征的显示上，MPR联合VR均优于TSCT，差异有统计学意义（P＜0.05或0.01）。3位阅片医师（A、B、C）采用MPR联合VR诊断的灵敏度和正确率均明显优于采用TSCT，差异均有统计学意义（均P＜0.05），而特异度差异均无统计学意义（均P＞0.05）；MPR联合VR诊断结果与病理金标准的一致性（A：κ=0.773，B：κ=0.754，C：κ=0.783）以及阅片医师之间的一致性（A和B：κ=0.743，B和C：κ=0.789，A和C：κ=0.751）均优于TSCT。结论MPR联合VR能显著提高对直径≤1.0cm肺小结节早期诊断效能。 |
| 关键词: 肺小结节 肺癌 CT 薄层扫描 多平面重建 容积再现重建 |
| DOI： |
| 分类号: |
| 基金项目:国家卫生计生委科学研究基金 |
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| Multi-plane reconstruction combined with volume rendering in diagnosis of small-size pulmonary nodules |
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TAN Linlin,XU Liyun,WANG Sshanjun,ZHANG Shanhua,YAN Jie,WANG Zhaoyu,ZHANG Yongkui
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Affiliated Zhoushan Hospital of Wenzhou Medical University
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| Abstract: |
| Objective To evaluate the application of multi-plane reconstruction combined with volume rendering
（MPR/VR）in diagnosis of pulmonary small-size nodules(≤1.0cm in diameter). Methods The MPR/VR and thin-section com- puted tomography(TSCT) findings of 159 consecutive patients with pulmonary small-size nodules were retrospectively reviewed. As the histopathological diagnosis as the gold standard the diagnostic sensitivity，specificity and accuracy of MPR/VR and TSCT were analyzed with receiver operating characteristic curve (ROC). Results MPR/VR was significantly superior to TSCT in demonstrating spiculation (P＜0.05), lobulation(P＜0.01), vascular convergence (P＜0.05) and pleural tag(P＜0.01). The perfor- mance of observers A, B, and C with MPR/VR was better than that with TSCT(P＜0.05, P＜0.05 and P＜0.05, respectively). Sensi- tivity and accuracy of MPR/VR was significantly better than that of TSCT for all observers (sensitivity: all P＜0.01; accuracy: A: P＜ 0.01, B: P＜0.01, C: P＜0.05), while there were no significant differences in specificity (P ＞0.05) between MPR/VR and TSCT. Consistency between MPR/VR and the gold standard (A: κ=0.773, B: κ=0.754, C: κ=0.783) and inter-observer agreement (A and B: κ=0.743, B and C: κ=0.789, A and C: κ=0.751)were satisfactory. Conclusion MPR combined with VR can significantly improve the diagnosis of pulmonary small-size nodules. |
| Key words: Small-sized pulmonary nodules Lung cancer Thin-section computed tomography Multi-plane recon- struction Volume rendering |
