Diagnostic Value Of "heteromorphic Vessel Sign In Tumor" To Lung Cancer With Contrast Enhanced MDCT

Objective:Through the Multidetector Computed Tomography tecnology(MDCT) to enhance the comprehensive application of scanning and thin slice reconstruction and multiple planar reconstruction(MPR)after treatment technology, to discuss the sensitivity and specificity of single factor "heteromorphic vessel sign in tumor" for the diagnosis of lung cancer, lung cancer and combined with " lobulation", "speculation sign", " pleural indentation", " vascular convergence sign" and so on the many kinds of conventional CT findings of ROC curve and Logistic regression analysis, to explore the "heteromorphic vessel sign in tumor" on lung space occupying lesions, diagnosis of benign and malignant differential value.Methods:Collect confirmed by pathology in 217 patients with lung cancer(including 41 cases after operation, CT guided percutaneous lung puncture in 91 cases and fiberoptic bronchoscopy biopsy in 85 cases). Benign lesions also collected 32 patients as control group. All patients underwent enhanced MDCT scanning and some of them also do thin slice reconstruction and MPR before treatment. For blind reading by 2 experienced physicians, respectively, on the site of lesion, size, shape, edge and enhanced "heteromorphic vessel sign in tumor" comprehensive reading and recording the results; all the collected data are using statistical analysis software package SPSS13.0 for statistical processing.Results:1. single factor analysis of pulmonary lesions appear "heteromorphic vessel sign in tumor" suggests a higher risk of malignancy, with a statistically significant difference(χ2=22.249, P<0.001). Conventional 10 mm thickness scan mode observed the emergence of "heteromorphic vessel sign in tumor" for lung cancer diagnosis sensitivity was 57.1%, specificity was 87.5%, shown in the image processing features of lung cancer diagnosis sensitivity of 79.3% in thin 1mm reconstruction and MPR, the specificity was 84.4%. 2. "heteromorphic vessel sign in tumor" occurs in between the peripheral lung cancer in central type lung cancer had no statistically significant difference(χ2=2.057, p=0.151). 3. "heteromorphic vessel sign in tumor" appeared in adenocarcinoma and squamous cell carcinoma(χ2=1.891, p=0.169), adenocarcinoma and small cell lung cancer between(χ2=1.729, p=0.189), squamous cell carcinoma and small cell lung cancer between(χ2=0.282, p=0.595) had no statistically significant difference in. 4.A variety of CT signs of assignment ROC curve analysis suggesting that the differential diagnosis of benign and malignant, combination of CT signs of lesions in the lungs of larger value. If use 1.5 for the diagnosis of malignant threshold, maximum value calculation of Youden’s value, suggests the diagnosis performance, sensitivity and specificity were 96.3% and 62.5%. 5. Multivariate Logistic regression analysis showed that high correlation between "heteromorphic vessel sign in tumor", "liquefaction necrosis syndrome", " speculation sign" and lung cancer. there was statistically significant difference, the OR value of "heteromorphic vessel sign in tumor" is 17.483, indicate that the presence of the signs of the evil inclination degree are 17.483 times more likely than benign the.Conclusions : Enhancement scanning by Multi-detector Computed Tomography technology(MDCT), especially the combined application of thin slice reconstruction and multiple planar reconstruction(MPR)after treatment technology, the emergence of "heteromorphic vessel sign in tumor" has a high value of lesions in differential diagnosis of pulmonary lung mass, combined with " lobulation", "speculation sign", " pleural indentation", " vascular convergence sign" and other conventional CT signs of ROC curve and Logistic regression analysis, provide a quantitative basis for lung space occupying lesion in the differential diagnosis of.