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螺旋CT后处理技术 在肺癌分期中的应 用价值研究

作者:牛智祥1 周志刚2

所属单位:1.河南省义马市义马煤业集团股份 有限公司总医院影像科 (河南 三门峡 472300) 2.郑州大学第一附属医院放射科 (河南 郑州 450000)

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摘要

目的 研究螺旋CT后处理技术对 肺癌分期的诊断价值。方法 以本院2013 年1月-2015年12月经病理证实的120例肺 癌患者为研究对象,术前均行常规横断 面CT扫描、增强扫描及其后处理技术(多 平面重组、容积再现、最大密度投影等) 应用,以病理分期结果为对照,比较CT 横断面、后处理技术对肺癌TNM分期的诊 断符合率。结果 T分期:MSCT后处理图 像T2诊断符合率92.1%,T3符合率87.5%, T4符合率86.9%,均显著高于横断面图像 的60.5%、59.4%、60.9%(P<0.05)。N分 期:MSCT后处理图像诊断N1、N2符合率分 别为90.5%、90.6%,均显著高于横断面 图像的66.7%、62.5%(P<0.05)。MSCT后 处理技术能正确显示远处脏器转移。TNM 分期:MSCT后处理图像对II期、III期、 IV期诊断符合率分别为90.6%、89.5%、 100.0%,显著高于横断面图像的65.6%、 63.2%、0.0%(P<0.05)。结论 MSCT后处 理技术对肺癌TNM分期诊断准确率高,术 前利用MSCT后处理技术准确判断TNM分期 以为肺癌临床治疗提供依据。

Objective To study the diagnostic value of spiral CT postprocessing techniques in staging of lung cancer. Methods 120 cases of patients with lung cancer confirmed by pathology in our hospital between January 2013 and December 2015 were selected as the study objects. Before operation, routine cross-sectional CT scan and enhanced scan were performed and postprocessing techniques (multiplanar reconstruction, volume rendering, maximum intensity projection, etc.) were applied. The results of pathological staging were taken as control to compare the diagnostic coincidence rates of CT cross section and postprocessing techniques in TNM staging of lung cancer. Results T staging: The diagnostic coincidence rate of MSCT postprocessing image T2 was 92.1% of T3 was 87.5% and of T4 was 86.9% which were significantly higher than those of cross-sectional images (60.5%, 59.4%, 60.9%) (P<0.05). N staging: The coincidence rates of MSCT postprocessing images in diagnosis of N1 and N2 (90.5%, 90.6%) were significantly higher than those of cross-sectional images (66.7%, 62.5%) (P<0.05). MSCT postprocessing techniques can correctly display distant organ metastasis. TNM staging: The coincidence rates of MSCT postprocessing images in diagnosis of II phase, III phase and IV phase (90.6%, 89.5%, 100.0%) were significantly higher than those of cross-sectional images (65.6%, 63.2%, 0.0%) (P<0.05). Conclusion The accuracy of MSCT postprocessing techniques in the diagnosis of TNM staging of lung cancer is high. Before operation, MSCT postprocessing technique can be used to accurately determine TNM staging to provide basis for clinical treatment.

【关键词】螺旋CT;后处理技术;肺癌; TNM分期

【中图分类号】R445.3;R734.2

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2017.10.014

前言

据统计,美国2011年新增肺癌人数221000例左右,死亡约15700 例,5年总体生存率不到16.0%[1]。近年来肺癌逐渐成为威胁人类生命 的主要恶性肿瘤之一。目前临床公认肺癌正确分期是疾病干预方案制 定、患者预后判断的重要依据,且当下以第7版肺癌TNM分期为主[2]。 多层螺旋CT(MSCT)技术具有快速扫描、覆盖范围大、图像重组及后处 理技术强大等特点,有效弥补常规横断面CT对肺癌分期诊断的局限 性,通过对原发肿瘤、淋巴结、远处转移与否等情况全面反映,为肺 癌术前TNM分期提供客观、准确参考资料[3]。目前临床关于MSCT后处理 技术对肺癌TNM分期诊断符合率报道较少,基于此,本研究以病理分期 结果为标准,通过与常规横断面CT结果比较,分析MSCT后处理技术对 肺癌分期的诊断价值。现报告如下。