中国临床医学影像杂志2025，Vol.36Issue(7)：474-477,4.DOI:10.12117/jccmi.2025.07.005
不同CT重建参数在肺结节良恶性鉴别中的诊断价值
Value of different CT reconstruction parameters in differentiating malignant from benign lung nodules
摘要
Abstract
Objective:To evaluate the value of different CT reconstruction parameters in differentiating malignant from be-nign lung nodules.Methods:One hundred and fifty-three patients with lung nodules were scheduled to undergo thoracic surgery in our hospital from June 2021 to July 2023 were retrospectively selected.All patients were divided into 4 groups ac-cording to CT techniques(plain or contrast enhanced scans),different radiation doses,and different image reconstruction algo-rithms(adaptive statistical iterative reconstructions-V(ASiR-V)or filtered backprojection(FBP)):group 1(contrast scan+50％ASiR-V+conventional dose),group 2(contrast scan+50％ASiR-V+low dose),group 3(plain scan+50％ASiR-V+conventional dose),and group 4(contrast scan+FBP+conventional dose).The clinical data of patients were recorded,and the reconstructed images of the four groups were analyzed.Taking pathological examination as the"gold standard",the diagnostic accuracy was analyzed.ROC curve was plotted to evaluate the efficacy of different CT reconstruction parameters in differentiating malignant from benign lung nodules.The Delong method was used to compare the AUC of different reconstruction parameters pairwise.Results:Pathological biopsies classified 234 lesions in 153 patients with lung nodules into malignant group(88 lesions)and benign group(146 lesiona).Malignant group detected a greater number of nodules and a larger diameter of the largest lesion compared to benign group(P＜0.05).A total of 140 malignant and 94 benign nodules were diagnosed in group 1,115 malignant and 119 benign nodules were diagnosed in group 2,123 malignant and 111 benign nodules were diagnosed in group 3,and 125 ma-lignant and 109 benign lung nodules were diagnosed in group 4.The differences in diagnostic sensitivity,accuracy,positive predictive value,and negative predictive value of different reconstruction algorithms,contrast agents,and radiation doses were not statistically significant(P＞0.05).Groups 2,3 and 4 had AUC of 0.758,0.762 and 0.721 for lung nodules,while group 1 reached an AUC of 0.808,which was larger than that of groups 2,3 and 4,with a sensitivity and specificity of 77.24％and 81.98％,respectively.The Delong test shows that the difference between group 1 and group 4 is statistically significant(z=1.983,P=0.047).Conclusion:Contrast-enhanced CT scan and reconstruction algorithms have an impact on the diagnostic effi-cacy of benign and malignant lung nodules.关键词
肺疾病/肺肿瘤/体层摄影术,X线计算机Key words
Lung Diseases/Lung Neoplasms/Tomography,X-Ray Computed分类
医药卫生引用本文复制引用
李晶晶,谢兴武,夏青..不同CT重建参数在肺结节良恶性鉴别中的诊断价值[J].中国临床医学影像杂志,2025,36(7):474-477,4.基金项目
2021年度湖北省教育厅科学研究计划项目(编号:B2021447). （编号:B2021447）
