基于CT平扫的预测模型对肺梗死与胸膜下肺炎的鉴别诊断价值

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ValueofapredictivemodelofCTnon-enhancedfeatures indiferentialdiagnosisbetweenpulmonaryinfarctionand pneumonia

DONGHaixia，ZHANG Youjun，JIANG Ruisheng，ZHANGWanwei，JIANG Changqin

Department ofMedical Imaging，Weifang Yidu Central Hospital，Weifang 2625oo，China.

[Abstract]Objective：ToexplorethevalueofapredictivemodelofCTnon-enhancedfeaturesindiferentialdiagnosis betweenpulmonaryinfarctionandpneumonia.Methods：Chest CTimagesof29patientswithpulmonary infarctionand 35patientswithpneumoniawereanalyzedretrospectively.Univariateandmultivariatelogisticregressionanalysiswere performedtoanalyzethefactors，includingthewedgesign，vascularsign，reversedhalosign，pleuralthickening，decreased proximalcardiactransmitance，lungvolumereduction，pleuralefusion，venousbranchsign，andairbronchogramsignAndthe predictivemodelwasestablished.ROCcurvewasusedtoanalyzethediagnosticeficacy.Results：Therewerestatitically significantdiferencesinthewedgesign，vascularsign，reversedhalosign，pleuralthickening，decreasedproximalcardiac transmittance，lung volume reduction，pleural effusion，venous branch sign （all P<0.05 ）.The venous branch sign was more commoninpneumonia，theotherfeaturesweremorecommoninpulmonaryinfarction.Multivariatelogisticregresionanalysis showed hat wedgesignwasindependentpredictorof pulmonaryinfarction，whilevenousbranch signwasprotective factorof pneumonia.TheAUCofthecombinedmodelconstructedwithwedgesignandvenousbranchsignreachedO.925，higherthan that of wedge sign and vascular sign separately （both P<0.05 ）. Conclusion：The combined model constructed with wedge sign and venous branch sign can accurately diffrentiate pulmonary infarction from pneumonia.

[Keywords] Pulmonary Infarction;Pneumonia;Tomography，X-ray computed;Nomogram

肺血栓栓塞症（pulmonarythromboembolism，PTE）是常见的内科危重症之一，发病率和病死率均较高[1-2]。（剩余7708字）