多平面重建在弥漫性肺疾病中的应用价值

目的评价多层螺旋CT(MDCT)多平面重建(MPR)对肺弥漫性病变的诊断价值。资料与方法对67例经临床确诊表现为肺内弥漫性病变的病例进行MDCT扫描和薄层冠状位MPR,并与轴位高分辨率CT(HRCT)比较。图像分析共分3组,2人3次完成阅片。结果轴位HRCT和冠状位MPR评价磨玻璃密度影、气腔样实变和小结节等高密度病灶和含气病灶的敏感度分别是100%和87%～100%,特异性分别为100%和97%～100%,差别无显著性。HRCT和MPR图像在显示肺内细网状影、线样影和牵张性细支气管扩张的敏感度分别为92%～100%和71%～100%,特异性分别为88%～100%和90%～100%,差别无显著性。HRCT和MPR图像在评价肺弥漫性病变的分布上无显著性差别。观察者对MPR评价磨玻璃密度影、气腔样实变和蜂窝影、肺气肿、肺大泡的满意度较高(95%～100%);对线样影、细网状影、小结节或微结节、牵张性支气管扩张等的满意度较低(10%～68%),差别有显著性(P<0.05)。结论目前采用1.25mm准直的MDCT扫描所得的MPR图像在评价磨玻璃密度影、肺实变、蜂窝影和肺气肿、肺大泡等病变的能力等同于轴位HRCT;评价线样影、细网状影及牵张性支气管扩张和微结节等病变的能力不及轴位HRCT。

Usefulness of Multiplannar Reconstruction with Multidetector-Row Computed Tomography in Diffuse Lung Diseases

Objective To evaluate the diagnostic value of multiplannar reformations (MPR) using multidetector-row computed tomography (MDCT) for the diffuse lung diseases.Materials and Methods 67 patients with diffuse lung diseases proved by clinic were underwent with MDCT and thin-thickness coronal MPR images, and compared with axial HRCT images. Analysis of images were divided into 3 groups, two observers independently analyzed the overall image in 3 times. Results The sensitivity and specificity of axial HRCT in evaluating ground-grass opacities, air-space consolidations, micronodules, linear opacities were 92%-100% and 88%-100%, respectively. The sensitivity and specificity of coronal MPR images were 71%-100% and 90%-100%, respectively, which were no differeance. Satisfaction rating with coronal MPR images in evaluating ground-grass opacities, air-space consolidations, honeycombing, emphysema and bulla were 95%-100%. Satisfaction rating with coronal MPR images in evaluating micronodules, linear opacities, fine reticular opacities and traction bronchiectasis were 10%-68%, which were significant difference (P<0.05).Conclusion Thin-thickness coronal MPR images is equal or superior to axial HRCT in evaluating ground-grass opacities, air-space consolidations, honeycombing, emphysema and bulla. Thin-thickness coronal MPR images is inferior to axial HRCT in evaluating micronodules, linear opacities, fine reticular opacities and traction bronchiectasis.