摘要
目的:探讨应用改良最大似然法对周围型肺癌、良性肿瘤、结核球及炎性结节4种孤立肺结节(SPN)的鉴别诊断价值。方法:按要求筛选国内文献病例建立改良最大似然法评价方法,然后对我院证实的60例SPN(56例病理证实,2例结核球及2例炎性结节经临床证实)进行盲法回顾性诊断分析,其中周围型肺癌36例、良性肿瘤6例、结核球8例、炎性结节10例,其结果与病例中记录(常规阅片法)的诊断结果行比较。结果:筛选出10个常见CT征象建立改良最大似然法评价方法,60个SPN的诊断正确率分别为周围型肺癌80.5%(29/36)、良性肿瘤83.5%(5/6)、结核球75.0%(6/8)及炎性结节80.0%(8/10),总的诊断正确率为80.0%(48/60);常规阅片法诊断正确率分别为周围型肺癌69.4%(25/36)、良性肿瘤66.7%(4/6)、结核球62.5%(5/8)及炎性结节70.0%(7/10),总诊断正确率为68.3%(41/60);最大似然法诊断正确率略高于常规阅片法,但未见统计学显著性差异(χ2=1.89,P=0.167>0.05)。结论:改良最大似然法对SPN的诊断有较好的准确率,有可能高于常规阅片法,可用于指导日常阅片工作,尤其是年轻医师或基层医院医师的工作。
Purpose： To evaluate the value of the maximum likelihood method in differentiating the four kinds of SPN among peripheral lung carcinomas,benign tumors,tuberculomas,inflammatory nodules.Methods：Sixty cases of pathologically or clinically proved SPN were collected in our study,including 36 cases of peripheral carcinomas,6 benign tumors,8 tuberculomas,10 inflammatory nodules.Maximum likelihood method was used for analyzing these 60 cases of SPN.Comparison was made between diagnostic results from the use of traditional method and the maximum likelihood method.Results： The diagnostic accuracy with the maximum likelihood method of peripheral lung carcinoma,benign tumor,tuberculoma,inflammatory nodule were 80.5%（29/36）,83.5%（5/6）,75.0%（6/8）,80.0%（8/10）.The mean accuracy was 80.0%（48/60）.The diagnostic accuracy with the routine diagnostic method of peripheral lung carcinoma,benign tumor,tuberculoma,inflammatory nodule were 69.4%（25/36）,66.7%（4/6）,62.5%（5/8）,70.0%（7/10）.The mean accuracy was 68.3%（41/60）.Although the mean accuracy of former method was higher than the latter,there was no statistical difference（χ2=1.89,P=0.1670.05）.Conclusion： The maximum likelihood method is useful for the diagnosis of SPN.When compared with the traditional method.Though without statistically significance,it still can be applied to the daily routine study.
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2011年第1期32-36,共5页
Chinese Computed Medical Imaging
