Analysis of the Efficacy of Thin-slice MSCT Reconstruction in the Differential Diagnosis of Pulmonary Micronodules of Different Natures

ZHUANG Qingfeng; LI Xiaowei

doi:10.3969/j.issn.1002-3429.2025.13.007

Abstract：Objective To analyze the efficacy of thin-slice multi-slice spiral CT(MSCT)reconstruction in the differ-ential diagnosis of pulmonary micronodules of different natures.Methods A total of 204 patients with suspected pulmonary micronodules who visited the hospital from March 2021 to March 2024 were selected and all underwent thin-slice MSCT ex-amination.The detection rate of thin-slice MSCT for pulmonary micronodules was analyzed,and taking the pathological results as the gold standard,the Kappa consistency test was used to analyze the efficacy of thin-slice MSCT in diagnosing pulmonary micronodules.Results Among the 204 patients with suspected pulmonary micronodules,there were a total of 236 nodules.Among them,84 were diagnosed by pathological examination,and thin-slice MSCT was used in diagnosing pulmonary micro-nodules.The detection rate,misdiagnosis rate and missed diagnosis rate of pulmonary micronodules diagnosed by multiplanar reconstruction(MPR)were 39.41%,8.47%and 4.66%,respectively.The detection rate,misdiagnosis rate and missed diagnosis rate of volume reproduction(VRT)were 40.68%,8.90%and 3.81%,respectively.The detection rate,misdiagnosis rate and missed diagnosis rate of the combined detection were 43.64%,9.75%and 1.69%,respectively.For the diagnosis of pulmonary micronodules by thin-slice MSCT,the diagnostic sensitivities of MPR,VRT detection alone and in combination were 86.90%,89.29%and 95.24%,respectively,the specificities were 86.84%,86.18%and 84.87%,respectively,and the Kappa values were 0.720,0.731 and 0.762,respectively.Among 84 patients with pulmonary micronodules,46 micronodules were diagnosed as be-nign and 38 as malignant by the gold standard,including 28 inflammatory nodules,19 adenocarcinomas,17 squamous cell car-cinomas,11 hamartomas,7 benign granulomas,and 2 metastatic tumors.After thin-slice MSCT detection,the coincidence rates of MPR,VRT and detection alone and in combination in diagnosing pulmonary micronodules of different natures were 73.81%,76.19%and 82.14%,respectively,and the Kappa values were 0.698,0.707 and 0.726,respectively.Conclusion In the differ-ential diagnosis of pulmonary micronodules,various reconstruction methods of thin-slice MSCT can be used for differentiation through the image differences of benign and malignant pulmonary micronodules,significantly improving the accuracy of differ-ential diagnosis.