宝石能谱CT成像在肺癌病理分类诊断的价值探讨

发布时间：2018-05-04 07:45

本文选题：肺癌 + 能谱成像　；参考：《长江大学》2017年硕士论文

【摘要】：目的:讨论宝石能谱CT成像技术(Gemstone spectral imaging,GSI)在不同病理类型肺癌中鉴别诊断的价值。材料和方法:回顾性分析2015年5月至2016年10月于荆州市第一人民医院行宝石能谱CT检查并经手术或CT引导下穿刺病理证实的106例肺癌(肺鳞癌39例、肺腺癌42例、小细胞肺癌17例、大细胞肺癌8例)患者的能谱CT资料,选取动脉期扫描数据,测量不同病理类型肺癌病灶的钙含量、水含量、有效原子序数、40~80keV间的能谱衰减曲线斜率以及动脉期的标准化碘浓度(Normalized Iodine Concentration,NIC),分析比较各项能谱数据在不同病理类型肺癌鉴别诊断的价值。结果:1.肺鳞癌组、肺腺癌组、肺小细胞肺癌组、肺大细胞肺癌组的标准化碘浓度分别为:0.07±0.03、0.12±0.06、0.05±0.03、0.05±0.02;肺鳞癌组与肺腺癌组、肺鳞癌组与肺小细胞肺癌组、肺鳞癌组与肺大细胞肺癌组、肺腺癌与肺大细胞肺癌组、肺腺癌组与肺小细胞肺癌组之间差异有统计学意义(P0.05);肺小细胞肺癌组与肺大细胞肺癌组之间没有统计学意义(P0.05)。2.肺鳞癌组、肺腺癌组、肺小细胞肺癌组、肺大细胞肺癌组的钙含量(mg/ml)分别为9.59±5.29、5.83±3.84、2.65±1.47、4.08±1.55;肺鳞癌组与肺腺癌组、肺鳞癌组与肺小细胞肺癌组、肺鳞癌组与肺大细胞肺癌组、肺小细胞肺癌组与肺大细胞肺癌组之间差异有统计学意义(P0.05);肺腺癌与肺大细胞肺癌组之间没有统计学意义(P0.05);3.肺鳞癌组、肺腺癌组、肺小细胞肺癌组、肺大细胞肺癌组的水含量(mg/ml)分别为1060.63±34.87、1038.56±28.36、1040.88±17.83、1036.84±8.26;肺鳞癌组与肺腺癌组、肺鳞癌组与肺小细胞肺癌组、肺鳞癌组与肺大细胞肺癌组之间差异有统计学意义(P0.05);肺腺癌与肺大细胞肺癌组、肺腺癌组与肺小细胞肺癌组、肺小细胞肺癌组与肺大细胞肺癌组之间没有统计学意义(P0.05);4.肺鳞癌组、肺腺癌组、肺小细胞肺癌组、肺大细胞肺癌组的有效原子序数分别为7.87±0.27、8.01±0.31、7.73±0.32、7.90±0.46;肺鳞癌组与肺腺癌组、肺腺癌组与肺小细胞肺癌组之间差异有统计学意义(P0.05);肺鳞癌组与肺小细胞肺癌组、肺鳞癌组与肺大细胞肺癌组、肺腺癌与肺大细胞肺癌组、肺小细胞肺癌组与肺大细胞肺癌组之间没有统计学意义(P0.05);5.肺鳞癌组、肺腺癌组、肺小细胞肺癌组、肺大细胞肺癌组的40~80Kev能谱曲线斜率分别为0.77±0.49、1.28±0.68、0.29±0.14、0.44±0.28;肺鳞癌组与肺腺癌组、肺鳞癌组与肺小细胞肺癌组、肺腺癌组与肺小细胞肺癌组、肺腺癌与肺大细胞肺癌组之间差异有统计学意义(P0.05);肺鳞癌组与肺大细胞肺癌组、肺小细胞肺癌组与肺大细胞肺癌组之间没有统计学意义(P0.05)。结论:不同类型肺癌具有不同的能谱特征参数,其中肺腺癌组的标准碘含量高于鳞癌组、肺大细胞肺癌及肺小细胞肺癌组;肺鳞癌组病灶的钙含量平均值大于肺腺癌组、肺大细胞肺癌及肺小细胞肺癌组;通过对肺癌瘤体内钙含量、水含量、有效原子序数、40~80keV间的能谱衰减曲线斜率以及动脉期的标准化碘浓度分析比较,可以帮助鉴别诊断不同来源的肺癌。
[Abstract]:Objective: to discuss the value of gemstone CT imaging (Gemstone spectral imaging, GSI) in the differential diagnosis of different pathological types of lung cancer. Materials and methods: a retrospective analysis of 106 cases of lung cancer (lung scale) confirmed by Gemstone spectrum CT examination and pathology confirmed by surgery or CT guided puncture from May 2015 to October 2016 in the first people's Hospital in Jingzhou. 39 cases of cancer, 42 cases of adenocarcinoma of lung, 17 cases of small cell lung cancer, 8 cases of large cell lung cancer, CT data, arterial phase scanning data were selected to measure the calcium content, water content, effective atomic number, the slope of energy spectrum attenuation curve between 40~80keV and the standardized iodine concentration (Normalized Iodine Concentrati) of the arterial phase (Normalized Iodine Concentrati). On, NIC), analysis and comparison of the value of various spectral data in the differential diagnosis of lung cancer in different pathological types. Results: the standard iodine concentration in 1. lung squamous cell carcinoma group, lung adenocarcinoma group, lung small cell lung cancer group and lung large cell lung cancer group was 0.07 + 0.03,0.12 + 0.06,0.05 + 0.03,0.05 + 0.02, lung squamous cell carcinoma group and lung adenocarcinoma group, lung squamous cell carcinoma group and lung small cell lung Cancer group, lung large cell lung cancer group, lung adenocarcinoma and lung large cell lung cancer group, lung adenocarcinoma group and lung small cell lung cancer group have significant difference (P0.05), there is no statistical significance between lung small cell lung cancer group and lung large cell lung cancer group (P0.05).2. lung squamous cell carcinoma group, lung adenocarcinoma group, lung small cell lung cancer group, lung large cell lung The calcium content (mg/ml) in the cancer group was 9.59 + 5.29,5.83 + 3.84,2.65 + 1.47,4.08 + 1.55; lung squamous cell carcinoma group and lung adenocarcinoma group, lung squamous cell carcinoma group and lung small cell lung cancer group, lung squamous cell carcinoma group and lung large cell lung cancer group, pulmonary small cell lung cancer group and lung large cell lung cancer group (P0.05), lung adenocarcinoma and lung large cell lung cancer group There was no statistical significance (P0.05); the water content of 3. lung squamous cell carcinoma group, lung adenocarcinoma group, lung small cell lung cancer group and lung large cell lung cancer group was 1060.63 + 34.871038.56 + 28.361040.88 + 17.831036.84 + 8.26, lung squamous cell carcinoma group and lung adenocarcinoma group, lung squamous cell carcinoma group and lung small cell lung cancer group, lung squamous cell carcinoma group and lung large cell lung cancer group The difference was statistically significant (P0.05); there was no statistical significance between lung adenocarcinoma and lung large cell lung cancer group, lung adenocarcinoma group and lung small cell lung cancer group, lung small cell lung cancer group and lung large cell lung cancer group (P0.05), and the effective atomic number of 4. lung squamous cell carcinoma group, lung adenocarcinoma group, lung small cell lung cancer group and lung large cell lung cancer group was 7.87 + 0.27,8.01, respectively. The difference between lung squamous cell carcinoma group and lung adenocarcinoma group, lung adenocarcinoma group and lung small cell lung cancer group was statistically significant (P0.05), pulmonary squamous cell carcinoma group and lung small cell lung cancer group, lung squamous cell carcinoma group and lung large cell lung cancer group, lung adenocarcinoma and lung large cell lung cancer group, pulmonary small cell lung cancer group and lung large cell lung cancer group were not unified. Study significance (P0.05); 5. lung squamous cell carcinoma group, lung adenocarcinoma group, lung small cell lung cancer group and lung large cell lung cancer group were 0.77 + 0.49,1.28 + 0.68,0.29 + 0.14,0.44 + 0.28; lung squamous cell carcinoma group and lung adenocarcinoma group, lung squamous cell carcinoma group and lung small cell lung cancer group, lung adenocarcinoma group and lung small cell lung cancer group, lung adenocarcinoma and lung large cell There was significant difference between lung cancer groups (P0.05). There was no statistical significance between lung squamous cell carcinoma group and lung large cell lung cancer group, lung small cell lung cancer group and lung large cell lung cancer group (P0.05). Conclusion: different types of lung cancer have different characteristic parameters of energy spectrum, and the standard iodine content of lung adenocarcinoma group is higher than that of squamous cell carcinoma group, lung large cell lung cancer and lung The average calcium content of the lesions in the lung squamous cell carcinoma group is greater than that of the lung adenocarcinoma group, the lung large cell lung cancer and the lung small cell lung cancer group. By comparing the calcium content, the water content, the effective atomic number, the slope of the energy spectrum attenuation curve between 40~80keV and the standard iodine concentration in the arterial phase, the differential diagnosis can help differential diagnosis. Lung cancer of the same origin.

【学位授予单位】：长江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2;R730.44

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