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[1]黄冬梅,刘 军,李福祥,等.四川省二级综合医院耐碳青霉烯类鲍曼不动杆菌感染发生的相关危险因素分析[J].中华肺部疾病杂志,2020,(03):355-359.[doi:10.3877/cma.j.issn.1674-6902.2020.03.013]
　Jia Ning,Zhang Haikuan,Leng Ailing..Clinical analysis of high-resolution CT, chest plain film and pathological examination in diagnosis of pulmonary ground-glass nodules[J].,2020,(03):355-359.[doi:10.3877/cma.j.issn.1674-6902.2020.03.013]
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四川省二级综合医院耐碳青霉烯类鲍曼不动杆菌感染发生的相关危险因素分析(PDF)

《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2020年03期
页码:
355-359
栏目:
论著
出版日期:
2020-06-20

文章信息/Info

Title:
Clinical analysis of high-resolution CT, chest plain film and pathological examination in diagnosis of pulmonary ground-glass nodules
作者:
黄冬梅1; 刘 军1; 李福祥2; 樊 丽3; 敬颖洁4; 肖 鹏5
610400 成都,金堂县第一人民医院呼吸内科1 610083 成都,西部战区总医院呼吸内科2 610500 成都,成都市新都区人民医院3 637300 南充,南部县人民医院4 641500资阳,乐至县人民医院5
Author(s):
Jia Ning;  Zhang Haikuan;  Leng Ailing.
Health Management Centre, Third Affiliated Hospital of Chongqing Medical University, Chongqing 401120, China
关键词:
二级医院;  鲍曼不动杆菌;  碳青霉烯;  耐药;  危险因素
Keywords:
Pulmonary ground-glass nodules;  High-resolution CT;  Chest plain film;  Pathology;  Differential diagnosis
分类号:
R563
DOI:
10.3877/cma.j.issn.1674-6902.2020.03.013
摘要:
目的 分析高分辨CT与胸部平片联合用于肺磨玻璃结节鉴别诊断的价值,以提高肺磨玻璃结节早期检出率,为临床合理治疗提供影像学依据。方法 选择2018年1月至2019年12月经手术病理结果或穿刺活检证实860例肺磨玻璃结节患者作为分析对象,全部患者在术前均接受胸部平片检查与高分辨CT检查,且均经高分辨率CT与胸部平片发现有肺部结节征象; 记录手术病理及穿刺活检结果; 观察患者胸部平片与高分辨CT检查主要征象,分析各检查方法单独及联合用于肺磨玻璃结节鉴别诊断的价值。结果 860例患者中经证实恶性385例,其中289例经手术病理确诊,96例经穿刺活检明确,包括原位腺癌135例,微浸润腺癌155例,浸润性腺癌72例,其他23例,恶性率为44.8%; 860例肺磨玻璃结节患者经胸部平片检查结果显示,肺结节直径范围为1.0～3.0 cm; 肺结节的分布:326例左肺,534例右肺; 经高分辨CT检查结果显示,良恶性病变肺磨玻璃结节病灶大小比较,差异无统计学意义(P>0.05),恶性结节表现出不规则形、毛刺征、分叶征、界面清楚光整、空泡征、支气管征等征象占比均高于良性组(P<0.05); 胸部平片、高分辨CT单独及联合诊断肺磨玻璃结节的曲线下面积分别为0.847、0.876、0.940,均>0.8,诊断价值好,且联合诊断的曲线下面积最大。结论 胸部平片与高分辨CT联合检测,并结合病理学对提高肺磨玻璃结节早期良性病变及恶性肿瘤进行鉴别诊断的正确率有重要价值。
Abstract:
Objective To analyze the clinical value of high-resolution CT combined with chest plain film in the differential diagnosis of pulmonary ground-glass nodules for increasing the early detection rate of pulmonary ground-glass nodules and providing imaging bases for clinical reasonable treatment. Methods A total of 860 patients with pulmonary ground-glass nodules which were confirmed by surgical pathological results or puncture biopsy from January 2018 to December 2019 were selected as the research objects. All the patients underwent chest plain film and high-resolution CT examination before surgery, and both the high-resolution CT and the chest plain film showed the signs of pulmonary nodules. The results of surgical pathology and puncture biopsy were recorded. The main signs of chest plain film and high-resolution CT of the patients were observed, too. The values of single and combined examination methods in the differential diagnosis of pulmonary ground-glass nodules were analyzed. Results A total of 385 cases were diagnosed as malignant lesions out of the 860 patients, of which 289 cases were confirmed by surgical pathology and 96 cases were confirmed by puncture biopsy, including 135 cases of adenocarcinoma in situ, 155 cases of minimally invasive adenocarcinoma, 72 cases of invasive adenocarcinoma and 23 other cases, with a malignant rate of 44.8%. The results of chest plain film of the 860 cases of pulmonary ground-glass nodules showed that the range of the pulmonary nodules'diameter was 1.0-3.0 cm. The distribution of the pulmonary nodules was described as follows: 326 cases located in the left lungs and 534 cases located in the right lungs. The results of high-resolution CT showed that there was no statistical difference in the size of focus between the benign and malignant pulmonary ground-glass nodules(P>0.05). The proportions of irregular shape, spicule sign, lobulation sign, clear and smooth interface, vocule sign, and bronchus sign in the malignant nodules were higher than those of the benign group(P<0.05). The areas under the curves of chest plain film, high-resolution CT alone and combined diagnosis of pulmonary ground-glass nodules were 0.847, 0.876, and 0.940, respectively, all of which were greater than 0.8, indicating good diagnostic values. And the area under the curve of combined diagnosis was the largest. Conclusion Chest plain film combined with high-resolution CT and pathological examination are of great value in improving the accuracy of differential diagnosis of early benign lesions and malignant pulmonary ground-glass nodules.

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备注/Memo

备注/Memo:
通信作者: 李福祥, Email: lfx98@163.com
更新日期/Last Update: 2020-06-20