双源CT双能量扫描对肺良恶性病变的鉴别诊断

发布时间：2018-01-31 10:53

本文关键词： 双源CT 体层摄影术 X线计算机肺肿瘤肺疾病　出处：《放射学实践》2015年01期 　论文类型：期刊论文

【摘要】：目的:探讨双源CT双能量扫描对鉴别诊断肺部良恶性肿块的价值。方法:选取72例肺肿块患者为研究对象,其中40例肺癌患者为观察组,32例炎性病变患者为对照组,72例患者均行双源CT双能量扫描,比较不同病变容积平均CT值、容积CT剂量指数值、平均容积CT增强值、容积CT净增值以及在不同keV下CT值衰减曲线,并计算不同标准化碘含量(NIC)阈值下CT检查的敏感度。结果:1观察组肿块体积、容积平均CT值、容积CT剂量指数值、平均容积CT增强值、容积CT净增值明显高于对照组,差异均有统计学意义(P0.05);2不同keV下腺癌和鳞癌CT值明显低于炎性病变,差异均有统计学意义(P0.05),但腺癌与鳞癌之间差异无统计学意义(P0.05);三组病变CT值曲线斜率分别为(-1.07±0.51)、(-1.12±0.41)及(-2.18±0.52),腺癌与鳞癌之间差异无统计学意义(P0.05),但均大于炎性病变(P0.05);3观察组NIC值为(0.273±0.089)mg/mL,明显低于对照组(0.417±0.107)mg/mL,差异有统计学意义(P0.05),对其进行ROC曲线分析得出NIC取值0.408mg/mL时,双源CT鉴别诊断良恶性病变的敏感度为0.862,特异度为0.626,曲线下面积为0.757,差异有统计学意义(P0.05)。结论:应用双源CT双能量扫描能对肺部良恶性病变在体积上进行鉴别,并且能通过不同keV CT值曲线斜率对肺部良恶性病变进行鉴别。
[Abstract]:Objective: to evaluate the value of dual-source CT dual-energy scanning in differential diagnosis of benign and malignant pulmonary masses. Methods: 72 patients with lung masses were selected as study objects, 40 patients with lung cancer as observation group. Thirty-two patients with inflammatory diseases were treated with dual-source CT dual-energy CT scanning. The mean CT values of different lesions, the volume CT dose index values and the average volume CT enhancement values were compared. The net increment of volume CT and the attenuation curve of CT value under different keV were calculated, and the sensitivity of CT under different standardized iodine content threshold was calculated. Results the volume of mass was observed in 1: 1 group. The volume average CT value, volume CT dose index value, average volume CT enhancement value and volume CT net increment were significantly higher than those in the control group (P 0.05). 2the CT value of adenocarcinoma and squamous cell carcinoma in different keV was significantly lower than that in inflammatory lesion, the difference was statistically significant (P 0.05), but there was no significant difference between adenocarcinoma and squamous cell carcinoma (P 0.05). The slope of CT curve in the three groups were -1.07 卤0.51 卤0.41) and -2.18 卤0.52 respectively. The difference between adenocarcinoma and squamous cell carcinoma was not statistically significant (P 0.05), but it was higher than that of inflammatory lesion (P 0.05). 3The NIC value of the observation group was 0.273 卤0.089 mg / mL, which was significantly lower than that of the control group (0.417 卤0.107 mg / mL, P 0.05). The ROC curve analysis showed that when the NIC value was 0.408 mg / mL, the sensitivity and specificity of dual-source CT in differential diagnosis of benign and malignant lesions were 0.862 and 0.626 respectively. The area under the curve was 0.757, the difference was statistically significant (P 0.05). Conclusion: Dual-source CT dual-energy scanning can distinguish benign and malignant lung lesions in volume. Moreover, the benign and malignant lung lesions can be distinguished by different keV CT curve slope.
【作者单位】：鹰潭市184医院放射科;江西省人民医院放射科;
【分类号】：R734.2;R816.4
【正文快照】： 肺癌是目前我国发病率及病死率最高的恶性肿瘤,且呈递增趋势。由于早期症状不明显,肺癌易于被患者忽略,多数患者确诊时已处于晚期,导致5年生存率不足15%[1]。因此,对肺部癌变早期、准确的诊断是有效治疗病变、提高患者5年生存率、降低病死率的关键。目前,临床上对肺癌的诊断主

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