容积倍增时间在64层螺旋CT诊断孤立性肺结节中的价值

The value of volume doubling time in diagnosis of solitry pulmonary nodules by 64-slice spiral CT

    摘要
  • 摘要:
    目的 探讨容积倍增时间（DTV）在64层螺旋CT诊断孤立性肺结节（SPN）中的价值。
    方法 初次胸部CT检查后，于第一个月末及第三个月末行2次以上随访的SPN患者46例，分别采用普通平扫横断面测量直径及LungCARE软件测定体积，计算所有结节的直径倍增时间（DTD）和DTV，比较两种测量方法对恶性肺结节的诊断价值；并用Mann-Whitney U非参数检验方法评价DTV在恶性SPN不同复查时期及不同病例类型之间的差异。
    结果 经临床和病理证实，46例SPN患者中，恶性肺结节29例（包括18例腺癌和11例鳞癌）、良性肺结节17例。DTV法与DTD法在恶性SPN诊断中的灵敏度、特异度、阳性预测率、阴性预测率和Youden指数分别为93.10%、94.11%、96.42%、88.89%和0.87 vs.79.31%、70.59%、82.14%、66.67%和0.50，DTV法的诊断价值显著优于DTD法（χ2＝10.211，P < 0.05）。腺癌与鳞癌患者第一个月末与第三个月末的DTV比较，差异无统计学意义（U＝0.127和U＝0.066，P均 > 0.05）。第一个月末及第三个月末，腺癌患者恶性肺结节的DTV显著大于鳞癌患者（U＝-3.193和U＝-2.810，P均 < 0.01）。
    结论 DTV法在64层螺旋CT诊断SPN中的效能优于DTD法。DTV可作为观察指标，评估不同性质SPN的生长特征，为肺结节的早期随访及定性诊断提供帮助。

     

    Abstract:
    Objective To discuss the value of volume doubling time(DTV)in diagnosis of solitry pulmonary nodules(SPN)by 64-slice spiral CT.
    Methods There were 46 cases which were underwent repeated follow-up CT at the first month and at the third month after the initial chest CT.We evaluated the value of DTV calculated by Lung CARE volumetry software and diameter doubling time(DTD)calculated by diameter method in the diagnosis of SPN.We compared the difference of DTV in different kinds of SPN and in different follow-up periods by Mann-Whitney U test.
    Results Twenty-nine malignant nodules and seventeen benign nodules were confirmed in forty-six SPN cases.The sensitivity, specificity, positive predictive value, negative predictive value and Youden index of DTV and DTD in the diagnosis of malignant nodules were 93.10%, 94.11%, 96.42%, 88.89%and 0.87 vs.79.31%, 70.59%, 82.14%, 66.67%and 0.50.The diagnostic value of DTVwas better than DTD(χ2＝10.211, P < 0.05).Furthermore, there were no differences in DTVbetween different follow-up periods(U=0.127 and U=0.066, P > 0.05)but significant differences between adenocarcinomas and squamous cell carcinomas(U=-3.193 and U=-2.810, P < 0.01).
    Conclusions The value of DTV in diagnosis of malignant nodule was superior to DTD.The evaluation of DTV may be helpful in assessing the growth characteristic of SPN and its follow-up.

     

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