RESUMO
Objective To assess the dignosis value of CT three-dimensional reconstruction with Fisher discriminant model in small solitary pulmonary nodules before operation.Methods CT data of 40 cases with SPN were retrospectively analyzed and divided into into malignant pulmonary nodules (25 cases),squamous cell carcinoma (4 cases),adenocarcinoma (13 cases),lung cancer (4 ca-ses),small cell lung cancer (2 cases),large cell carcinoma (1 case),metastases tumor (1 case),benign nodules (1 5 cases,6 cases of tuberculosis,2 cases of hamartoma,and 7 cases of non-specific inflammatory nodules)by pathology and follow-up results.The CT features of pulmonary nodules were evaluated through multi-planar reformation (MPR),curved-planar reformation (CPR),volume rendering (VR),maximum intensity proj ection (MIP)and other three-dimensional reconstruction.The three-dimensional data were divided into benign and malignant groups.In each of the two groups,the significant signs of morphological signs of discrimination indicators were adminstrated Fisher discriminant,and the probalitiy of false positives were estimated using cross-validation method. Results The positive features of pulmonary nodules in there-dismensional images were much more than in two-dimensional images. Fisher discriminant formula of solitary pulmonary nodules in three-dimensional images was Z=1.143X1 + 0.454X2+1.606X3-0.262X4+0.04X5+0.483X6+1.611X7-2.164.Discriminant boundary value Zc was-0.516.When Zcgreater than -0.516,nodules were proneed to considere as malignant nodules.In 25 cases of malignant nodules,4 cases mistook for benign.When Zc less than -0.516,nodules were proneed to considere as benign nod-ules.In 1 5 benign nodules,2 cases mistook for malignant.The total misdiagnosis and accuracy rate were 15 % and 85% respec-tively.Conclusion CT three-dimensional reconstruction combined with Fisher discriminant model have a high clinical value in dif-fereiating diagonsis of pulmonary nodules were proneed to considere as malignant nodules.In 25 cases of malignant nodules,4 cases mistook for benign.When Zc less than -0.516,nodules were proneed to considere as benign nodules. In 15 benign nodules,2 cases mistook for malignant.The total misdiagnosis and accuracy rate were 15 % and 85% respec-tively.Conclusion CT three-dimensional reconstruction combined with Fisher discriminant model have a high clinical value in differeiating diagonsis of pulmonary nodules.
RESUMO
Objective To explore the value of CT diagnosis in broadening of right upper mediastinum.Methods X-ray plain film and CT manifestations of broadening of right upper mediastinum in 56 cases proved by surgery and pathology or CT enhancement or heart ultrasound were analyzed. All cases were undergone radiography and CT scan. The contrast-enhanced CT scans were carried out in 51 cases.Results The study showed:un-invasive thymoma in 6 cases,invasive thymoma resulted in superior vena cava syndrome in 2 cases,intrathoracic thyroid tumors in 2 cases,ascending aorta or innominate artery dilatation in 14 cases,thoracic aortic aneurysm in 3 cases,pulmonary artery stenosis resulted in aortopulmonary dilatation in 1 cases,right sided aorta in 2 cases,lymphoma in 4 cases,the right mediastinal lung carcinoma in 16 cases,larvate focus of lung carcinoma in 2 cases,low esophageal carcinoma resulted in upper esophagectasia in 2 cases,foreign body of esophageal secondary upper mediastinal abscess in 2 cases. The cases proved by plain and contrast-enhanced CT scan,operation,pathology and heart ultrasound were 33,10,12 and 1 cases respectively. Conclusion CT scan is a effective method in the diagnosis of broadening of right upper mediastinum.