能谱CT成像对孤立性肺结节的诊断与病理对照研究

发布时间：2018-03-11 12:17

本文选题：孤立性肺结节　切入点：能谱成像　出处：《大连医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对孤立性肺结节(solitary pulmonary nodule,SPN)的能谱CT扫描中标准化碘浓度、有效原子序数及40-90ke V的能谱曲线斜率的定量测量,探讨能谱CT成像在孤立性肺结节定性诊断及病理分型中的应用。方法:选取2013年9月至2016年12月因孤立性肺结节就诊于我院的85例住院患者,其中男性49人,女性36人;年龄30-78岁,平均年龄46.7岁。所有入组患者均接受宝石能谱CT以能谱扫描模式(GSI)进行胸部双期增强扫描;所有诊断均经过手术病理或活检穿刺证实。包括:非结核性炎症17例、肺结核25例、恶性结节43例,其中包括腺癌(19例)、鳞癌(24例)。获得孤立性肺结节动脉期的标准化碘浓度、有效原子序数及40-90ke V能谱曲线斜率。所有数据应用SPSS统计分析软件(17.0版本)分析,定量资料采用均数±标准差表示,对非结核性炎症、肺结核、恶性肺结节与肺腺癌、肺鳞癌的动脉期标准化碘浓度、有效原子序数及40-90ke V能谱曲线斜率分别进行t检验,P0.05表示有统计学差异。结果:非结核性炎症组、肺结核组及恶性肺结节组动脉期标准化碘浓度及40-90ke V能谱曲线斜率存在差异,其中非结核性炎症组的标准化碘浓度及40-90ke V能谱曲线斜率均数最大,恶性肺结节组次之,肺结核组最小。而三组动脉期有效原子序数间差异没有统计学意义。非结核性炎症组与肺结核组、非结核性炎症组与恶性肺结节组、肺结核组与恶性肺结节组动脉期标准碘浓度及40-90ke V能谱曲线斜率均有统计学差异。肺腺癌组、肺鳞癌组动脉期标准化碘浓度、有效原子序数及40-90ke V能谱曲线斜率均有统计学差异。肺腺癌组标准碘浓度及有效原子序数均值大于肺鳞癌组。结论:动脉期标准化碘浓度及40-90ke V能谱曲线斜率可作为非结核性炎症、肺结核及恶性肺结节的鉴别诊断的指标,有助于三者的鉴别,亦可作为肺腺癌与肺鳞癌鉴别诊断的指标。能谱CT成像参数中的动脉期有效原子序数在鉴别非结核性炎症、肺结核及恶性肺结节中的价值有限,但可作为肺腺癌与肺鳞癌鉴别诊断的指标。
[Abstract]:Objective: to measure the concentration of iodine, the effective atomic number and the slope of the energy spectrum curve of 40 ~ 90ke V in solitary pulmonary noduleus (SPNs) by means of quantitative measurement of the concentration of iodine, the effective atomic number and the slope of the energy spectrum curve of the solitary pulmonary noduleus. Methods: from September 2013 to December 2016, 85 inpatients with solitary pulmonary nodules, 49 males and 36 females, were selected. The mean age was 46.7 years (30-78 years). All the patients in the group underwent double phase enhanced chest scan with energy dispersive scanning mode (GSI), all the patients were confirmed by surgical pathology or biopsy, including 17 cases of non-tuberculous inflammation. 25 cases of pulmonary tuberculosis, 43 cases of malignant nodules, including 19 cases of adenocarcinoma and 24 cases of squamous cell carcinoma. Effective atomic number and 40-90ke V spectral curve slope. All data were analyzed by SPSS statistical analysis software (version 17.0). The quantitative data were expressed as mean 卤standard deviation, for non-tuberculous inflammation, pulmonary tuberculosis, malignant pulmonary nodules and lung adenocarcinoma, There were significant differences in standardized iodine concentration, effective atomic number and 40-90ke V energy spectrum curve slope of lung squamous cell carcinoma by t test (P0.05). Results: Non-tuberculous inflammation group, In pulmonary tuberculosis group and malignant pulmonary nodule group, there were differences in standardized iodine concentration and 40-90ke V curve slope in arterial phase. The mean value of standardized iodine concentration and 40-90ke V energy spectrum curve in non-tuberculous inflammation group was the highest, followed by malignant pulmonary nodule group. The pulmonary tuberculosis group was the smallest. There was no significant difference in the effective atomic number among the three groups. The non-tuberculous inflammation group and the pulmonary tuberculosis group, the non-tuberculous inflammation group and the malignant pulmonary nodule group, There were significant differences between pulmonary tuberculosis group and malignant pulmonary nodule group in arterial phase standard iodine concentration and 40-90ke V curve slope, the arterial phase standardized iodine concentration in lung adenocarcinoma group, lung squamous cell carcinoma group, lung squamous cell carcinoma group, lung adenocarcinoma group, lung squamous cell carcinoma group, lung squamous cell carcinoma group, The mean values of standard iodine concentration and effective atomic number in lung adenocarcinoma group were higher than those in lung squamous cell carcinoma group. Conclusion: standardized iodine concentration and 40-90ke V energy spectrum curve slope can be obtained in arterial phase. As a non-tuberculous inflammation, The differential diagnosis of pulmonary tuberculosis and malignant pulmonary nodules is helpful to the differential diagnosis of pulmonary adenocarcinoma and lung squamous cell carcinoma. The effective atomic number of arterial phase in the parameters of EDS imaging is useful in differentiating non-tuberculous inflammation. The value of pulmonary tuberculosis and malignant pulmonary nodules is limited, but it can be used as a differential diagnosis between lung adenocarcinoma and lung squamous cell carcinoma.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R730.44;R734.2

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