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目的探讨多层螺旋CT三维(3D)重建技术在肺癌诊断及淋巴转移预测中的应用及其价值。方法以2013年3月至2015年12月间进行手术的肺癌患者86例作为研究对象,所有患者均于术前接受多层螺旋CT扫描并经图像后处理工作站进行3D重建。回顾性分析影像学与术后病理学检测结果的符合程度,判断其对肺癌辅助诊断及淋巴结转移的预测价值。结果多层螺旋CT三维重建对86例肺癌的成像结果显示,除细支气管征及空泡征外,3D成像肺癌典型征象显示率高于轴位成像(P均<0.01)。3D成像对淋巴结转移诊断的敏感度、特异度及准确度分别为93.44%、80.00%及89.53%,轴位成像的敏感度、特异度及准确度分别为73.77%、60.00%及69.77%,差异均有统计学意义(P均<0.05)。3D成像对淋巴结转移诊断效能明显优于轴位成像。3D图像转化为2D图像显示,有淋巴结转移的患者肿瘤血管密度明显高于无淋巴结转移患者[(0.07±0.04)vs(0.04±0.01),P<0.05]。结论多层螺旋CT三维重建对肺癌辅助诊断及淋巴转移预测具有良好的应用价值。
Objective To investigate the value and application of multi-slice spiral CT three-dimensional (3D) reconstruction in the diagnosis of lung cancer and prediction of lymphatic metastasis. Methods Totally 86 patients with lung cancer undergoing surgery from March 2013 to December 2015 were enrolled in this study. All patients underwent multi-slice spiral CT before surgery and were reconstructed by 3D post-processing workstation. Retrospective analysis of imaging and postoperative pathological findings meet the degree of judgment of its diagnosis of lung cancer and lymph node metastasis prediction. Results The imaging results of 86 cases of lung cancer showed that the typical signs of lung cancer in 3D imaging were higher than that of axial imaging (P <0.01) except for bronchioles and vacuolization. The sensitivity, specificity and accuracy of 3D imaging in diagnosis of lymph node metastasis were 93.44%, 80.00% and 89.53% respectively. The sensitivity, specificity and accuracy of axial imaging were 73.77%, 60.00% and 69.77% respectively. The differences All were statistically significant (P <0.05). 3D imaging is significantly superior to axial imaging in diagnosing lymph node metastases. The 3D images were converted to 2D images. The density of tumor vessels in patients with lymph node metastasis was significantly higher than that in patients without lymph node metastasis [(0.07 ± 0.04) vs (0.04 ± 0.01), P <0.05]. Conclusions Multi-slice spiral CT three-dimensional reconstruction of lung cancer diagnosis and lymph node metastasis has a good value.