Features of selective densitometry of spherical formations in lungs by the multispiral computed tomography


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Abstract

Detection calcificats in the spherical formations of lungs (SFL) by means of a multispiral computed tomography only confirms high sensitivity of this method to gradation of tissue density, but doesn’t increase differential opportunities. Their wrong interpretation as benign can entail inopportuneness of recognition and treatment. The radiological differential diagnostics of SFL based on the topological analysis of destruction cavities containing in them, allowing to specify a phase ofpathological process development, has a set of exceptions, signs aren’t constant and specific and therefore has no great diagnostic value. For the purpose of a comparative assessment of newly developed method of selective densitometry diagnostic opportunities at primary cancer, pneumonia and the infiltrative tuberculosis containing calcificats and/or cavities, 328 patients with SFL aged from 2 till 87 years are surveyed. In 131(39,9%) patients calcificats were visualized in SFL. In 77(23,7%) patients destruction cavities were visualized in SFL. Selective densitometry of SFL not containing and containing calcificats is carried out. Calcificats, containing in SFL, occur more often in infiltrative tuberculosis, than at primary cancer and pneumonia (p < 0,001) authentically more often. Again developed way of selective densitometry allows to carry out differential diagnostics of SFL, which aren t containing inclusions in a look calcificats (p < 0,001). Calcificats, containing in SFL, have specific (from densitometry positions) no criteria and their assessment doesn’t allow to carry out differential (p > 0,5). Inclusion containing in SFL calcificats and pathological process doesn’t allow to carry out differential diagnostics ofprimary cancer, pneumonia and infiltrative tuberculosis to the analysis (p > 0,5). The exception of the densitometrical analysis containing in SFL calcificats allows to carry out differential diagnostics of primary cancer, pneumonia and infiltrative tuberculosis (p < 0,001). At primary cancer of a lung statistically significant prevalence of cavities of destruction in comparison with pneumonia and infiltrative tuberculosis (p < 0,05) is defined. Destruction cavities, as a rule, settle down excentricly and have the wrong roundish form. Inclusion doesn’t allow to carry out differential diagnostics of primary cancer, pneumonia and infiltrative tuberculosis to the densitometrical analysis of sites of destruction containing in SFL (p > 0,5). The exception of the densitometrical analysis of sites of destruction containing in SFL allows to carry out differential diagnostics of primary cancer, pneumonia and infiltrative tuberculosis (p < 0,002; p < 0,001). Sensitivity at division of primary cancer - infiltrative tuberculosis made 91,1%, specificity - 88,6%, accuracy - 90,2%. Sensitivity at division of primary cancer - pneumonia made 90,4%, specificity - 74,5%, accuracy - 84,2%. Sensitivity at division of infiltrative tuberculosis - pneumonia made 79,5%, specificity - 80,8%, accuracy - 80,2%

About the authors

Vladimir K. Konovalov

Altai State Medical University

Email: kon4867@gmail.com
MD, PhD, DSci, Prof. 656038, Barnaul, Russian Federation

V. G Kolmogorov

Diagnostic center of the Altai territory

656038, Barnaul, Russian Federation

M. N Lobanov

Federal Center of Traumatology, Orthopedics and Endoprosthesis replacement

656045, Barnaul, Russian Federation

S. L Leonov

I.I. Polzunov Altai State Technical University

656038, Barnaul, Russian Federation

A. M Shayduk

Altai State Medical University

656038, Barnaul, Russian Federation

V. V Fedorov

Altai State Medical University

656038, Barnaul, Russian Federation

Ya. N Shoykhet

Altai State Medical University

656038, Barnaul, Russian Federation

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