中国临床医学影像杂志2026，Vol.37Issue(3)：186-190,5.DOI:10.12117/jccmi.2026.03.008
高分辨率CT靶向多期增强扫描联合三维重建技术评估肺结节良恶性的研究
Evaluation of benign and malignant pulmonary nodules by high resolution CT targeted multi-phase enhanced scanning combined with 3D reconstruction technology
摘要
Abstract
Objective:To investigate the application value of high-resolution computed tomography(HRCT)targeted multi-phase enhanced scanning combined with 3D reconstruction technology in the diagnosis of benign and malignant pulmonary nodules.Methods:A total of 142 patients with pulmonary nodules admitted to the Second People's Hospital of Lianyungang City from June 2021 to June 2024 were selected and divided into benign group(n=73)and malignant group(n=69)with patho-logical examination results as the gold standard.Imaging features and CT texture analysis results were compared between the two groups.The efficacy of HRCT targeted multi-phase enhanced scanning combined with 3D reconstruction technology in the diagnosis of benign and malignant pulmonary nodules was compared.Results:The proportions of patients with lymph node en-largement,spiculation/lobulation at the lesion edge,uneven internal structure,vascular involvement and uneven enhancement in the malignant group were higher than those in the benign group,and the difference was statistically significant(P<0.05).In the malignant group,grayrange(Ramge),haraentropy,maximum 3D diameter,gray-level co-occurrence matrix(GLCM)entropy,en-tropy,entropy sum,and entropy difference were all higher than those in the benign group.Energy,Short run low grey level emphasis(SRLGLE),and sphericity were lower than those in the benign group,the differences were statistically significant(P<0.05).There were 65 malignant cases and 77 benign cases diagnosed by HRCT targeted multi-phase enhanced scanning com-bined with 3D reconstruction technology,which was in good agreement with the gold standard detection results(Kappa=0.802).The results of multivariate analysis showed that lymph node enlargement,burrs/lobulation at the lesion edge,uneven internal structure,vascular involvement,uneven enhancement,Ramge,maximum 3D diameter,GLCM entropy and entropy were inde-pendent risk factors for the malignancy of pulmonary nodules,while energy and SRLGLE were independent protective factors(P<0.05).In the 5-fold cross-validation,the average area under the receiver operating characteristic(ROC)curve of the com-bined indicators for diagnosing malignant pulmonary nodules was 0.904,and the F1 value was 0.874.The sensitivity,speci-ficity,positive predictive value,negative predictive value and accuracy of HRCT targeted multi-phase enhanced scanning combined with 3D reconstruction technology in differentiating benign and malignant pulmonary nodules were 0.870,0.932,0.923,0.883 and 0.901 respectively.Conclusion:HRCT targeted multi-phase enhanced scanning combined with 3D recon-struction technology has important diagnostic value in the diagnosis of benign and malignant pulmonary nodules,and can ef-fectively improve the diagnostic accuracy.关键词
肺肿瘤/体层摄影术,X线计算机Key words
Lung Neoplasms/Tomography,X-Ray Computed分类
医药卫生引用本文复制引用
赵妍,耿磊,李桂芬..高分辨率CT靶向多期增强扫描联合三维重建技术评估肺结节良恶性的研究[J].中国临床医学影像杂志,2026,37(3):186-190,5.基金项目
连云港市科技局重点研发计划项目(SF2311). （SF2311）
