脊柱能谱CT定量参数鉴别骨髓瘤及骨转移瘤的应用研究

发布时间：2018-01-31 06:52

本文关键词： 能谱CT 肺癌骨转移瘤多发性骨髓瘤　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对肺癌溶骨性脊柱转移瘤和多发性骨髓瘤(multiple myeloma,MM)脊柱病灶进行宝石能谱CT扫描(GSI),测量并分析两组病灶单能量下的CT值和能谱曲线斜率,探究宝石能谱CT(GSI)在鉴别肺癌溶骨性脊柱转移瘤和多发性骨髓瘤脊柱病灶的应用潜力。方法:分析2016年4月至2017年1月期间在山西医科大学第二医院行能谱CT扫描的原发性肺癌伴脊柱溶骨性骨转移瘤患者17例及多发性骨髓瘤伴脊柱病灶的患者25例的图像,将扫描所得到的单能量原始数据重建成层厚、层间距为1.25 mm的薄层图像,(1)比较两种脊柱恶性肿瘤病灶感兴趣区在40~140keV(能量间隔为5keV)各单能量图像下的CT值,(2)绘制不同病灶的能谱曲线图,并计算分析能谱曲线斜率(本研究选40keV-90keV为参考点)即CT(40keV)-CT(90keV)/(90keV-40keV),对以上所得到的数据进行两样本的Mann Whitney U检验的统计学分析。结果:(1)肺癌骨转移病灶在40keV~90keV对应的CT值的中位数高于骨髓瘤病灶,P0.05,差别有统计学意义;(2)肺癌转移灶能谱曲线斜率(40keV-90keV为参考点)的中位数大于骨髓瘤病灶,P0.05,差别有统计学意义;(3)平扫后肺癌骨转移病灶与骨髓瘤病灶在95keV~140keV对应的CT值的中位数相互比较差别不大,P0.05,差别不具有统计学意义,结论:能谱CT能够准确测量并比较肺癌溶骨性脊柱骨转移和多发性骨髓瘤脊柱病灶的单能量下CT值及能谱曲线斜率,为临床提供更多有价值的定量影像学信息。其在脊柱的肺癌骨转移及多发性骨髓瘤的鉴别诊断中具有一定的应用价值。
[Abstract]:Objective: to study the value of gemstone energy dispersive computed tomography (SPECT) in the diagnosis of multiple myeloma (MM) and osteolytic spinal metastases of lung cancer. The CT value and the slope of the energy spectrum curve of the two groups were measured and analyzed. A study on Gem Energy Spectrum (CTG GSI). Potential in differentiating osteolytic spinal metastases from multiple myeloma spinal lesions in lung cancer. Methods:. From April 2016 to January 2017, 17 cases of primary lung cancer with osteolytic bone metastases and multiple myeloma with spinal lesions were analyzed in the second Hospital of Shanxi Medical University. Images were obtained from 25 patients. The original data of single energy are reconstructed into thin-layer images with thickness of layer and interval of 1.25 mm. 1) to compare the CT values of two types of spinal malignant tumors under 40 ~ 140keV (energy interval of 5 Kev) single energy images to draw the energy spectrum curves of different lesions. The slope of the energy spectrum curve (40keV-90keV as reference point) was calculated and analyzed. Statistical analysis of Mann Whitney U test of two samples for the data obtained above. Results: 1). The median CT value of bone metastases of lung cancer at 40 keV and 90 Kev was higher than that of myeloma. P0.05, the difference was statistically significant. (2) the median of energy spectrum curve slope of metastatic focus of lung cancer (40keV-90keV) was higher than that of myeloma (P 0.05), the difference was statistically significant. (3) there was no significant difference between the median CT value of bone metastases and myeloma lesions in 95 keV 140keV after plain scan (P 0.05). Conclusion: energy dispersive CT can accurately measure and compare the value of single energy CT and the slope of energy spectrum curve of osteolytic spinal bone metastasis and multiple myeloma of lung cancer. It can provide more valuable quantitative imaging information for clinical application in the differential diagnosis of bone metastasis and multiple myeloma of spinal lung cancer.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R733.3;R738;R730.44

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