Higashino Takanori, Ohno Yoshiharu, Takenaka Daisuke, Watanabe Hirokazu, Nogami Munenobu, Ohbayashi Chiho, Yoshimura Masahiro, Satouchi Miyako, Nishimura Yoshihiro, Fujii Masahiko, Sugimura Kazuro
Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.
Eur J Radiol. 2005 Oct;56(1):48-55. doi: 10.1016/j.ejrad.2005.04.002.
To determine the clinical utility of thin-section multiplanar reformats (MPRs) from multidetector-row CT (MDCT) data sets for assessing the extent of regional tumors in non-small cell lung cancer (NSCLC) patients.
Sixty consecutive NSCLC patients, who were considered candidates for surgical treatment, underwent contrast-enhanced MDCT examinations, surgical resection and pathological examinations. All MDCT examinations were performed with a 4-detector row computed tomography (CT). From each raw CT data set, 5mm section thickness CT images (routine CT), 1.25 mm section thickness CT images (thin-section CT) and 1.25 mm section thickness sagittal (thin-section sagittal MPR) and coronal images (thin-section coronal MPR) were reconstructed. A 4-point visual score was used to assess mediastinal, interlobar and chest wall invasions on each image set. For assessment of utility in routine clinical practice, mean reading times for each image set were compared by means of Fisher's protected least significant difference (PLSD) test. A receiver operator characteristic (ROC) analysis was performed to determine the diagnostic capability of each of the image data sets. Finally, sensitivity, specificity and accuracy of the reconstructed images were compared by McNemar test.
Mean reading times for thin-section sagittal and coronal MPRs were significantly shorter than those for routine CT and thin-section CT (p<0.05). Areas under the curve (Azs) showing interlobar invasion on thin-section sagittal and coronal MPRs were significantly larger than that on routine CT (p=0.03), and the Az on thin-section sagittal MPR was also significantly larger than that on routine CT (p=0.02). Accuracy of chest wall invasion by thin-section sagittal MPR was significantly higher than that by routine CT (p=0.04).
Thin-section multiplanar reformats from multidetector-row CT data sets are useful for assessing the extent of regional tumors in non-small cell lung cancer patients.
确定多排探测器CT（MDCT）数据集的薄层多平面重建（MPR）在评估非小细胞肺癌（NSCLC）患者区域肿瘤范围方面的临床实用性。
连续60例被认为适合手术治疗的NSCLC患者接受了增强MDCT检查、手术切除和病理检查。所有MDCT检查均使用4排探测器计算机断层扫描（CT）进行。从每个原始CT数据集中，重建了层厚5mm的CT图像（常规CT）、层厚1.25mm的CT图像（薄层CT）以及层厚1.25mm的矢状面（薄层矢状面MPR）和冠状面图像（薄层冠状面MPR）。采用4分视觉评分法评估每个图像集上的纵隔、叶间和胸壁侵犯情况。为评估在常规临床实践中的实用性，通过Fisher保护最小显著差异（PLSD）检验比较每个图像集的平均阅片时间。进行受试者操作特征（ROC）分析以确定每个图像数据集的诊断能力。最后，通过McNemar检验比较重建图像的敏感性、特异性和准确性。
薄层矢状面和冠状面MPR的平均阅片时间显著短于常规CT和薄层CT（p<0.05）。显示叶间侵犯的薄层矢状面和冠状面MPR的曲线下面积（Azs）显著大于常规CT（p = 0.03），薄层矢状面MPR的Az也显著大于常规CT（p = 0.02）。薄层矢状面MPR对胸壁侵犯的准确性显著高于常规CT（p = 0.04）。
多排探测器CT数据集的薄层多平面重建有助于评估非小细胞肺癌患者区域肿瘤的范围。
