能谱CT鉴别诊断孤立性肺结节或肿块的价值

发布时间：2018-04-23 10:35

本文选题：硬币病变 + 肺　；参考：《中国临床医学影像杂志》2017年04期

【摘要】：目的:探讨能谱CT成像定量分析在鉴别诊断肺癌、肺炎性肿块和肺结核中的价值。方法:收集经能谱CT增强扫描的78例肺结节或肿块患者,其中肺癌组38例、肺结核组20例、肺炎肿块组20例,测量动、静脉期病灶的单能量CT值、碘浓度(IC)、能谱曲线斜率(λ_(HU))、标准化碘浓度(NIC)及标准化水浓度(NWC)。对3组间上述参数进行单因素方差分析或秩和检验,并进行ROC曲线分析。结果:3组病变动、静脉期单能量CT值、IC、NIC及λ_(HU)差异均有统计学意义(P0.05)。两两比较肺炎组和结核组、肺癌组和结核组间差异有统计意义(P0.05),而肺炎组和肺癌组间差异无统计学意义(P0.05)。静脉期NIC0.325及NIC0.298时鉴别肺炎性肿块与肺结核、肺癌与肺结核的灵敏度分别为95.0%、97.4%,特异度分别为85.0%、75.0%。结论:运用宝石CT能谱成像的多参数定量分析可以鉴别肺癌和肺结核、肺炎性肿块和肺结核,但对肺炎性肿块与肺癌的鉴别诊断价值需进一步研究证实。
[Abstract]:Objective: to evaluate the value of quantitative analysis of energy dispersive CT imaging in differential diagnosis of lung cancer, pneumonic mass and pulmonary tuberculosis. Methods: a total of 78 patients with pulmonary nodules or masses, including 38 patients with lung cancer, 20 patients with pulmonary tuberculosis and 20 patients with pneumonic mass, were examined by energy dispersive computed tomography (EDS). The concentration of iodine, the slope of energy spectrum curve, the standard concentration of iodine and the concentration of standardized water are as follows: (1) the slope of energy spectrum curve (位), (2) the standard concentration of iodine (NIC) and (2) the concentration of standardized water. The above parameters were analyzed by single factor ANOVA or rank sum test, and ROC curves were analyzed. Results in the three groups, there were significant differences in the changes of disease, the value of single energy CT in venous phase, the value of ICG Nic and 位 subgroup (P 0.05). There was statistical significance between lung cancer group and tuberculosis group, but there was no significant difference between pneumonia group and lung cancer group. The sensitivity of lung cancer and pulmonary tuberculosis was 95.0 and 97.4, and the specificity was 85.0 and 75.0, respectively. Conclusion: multiparameter quantitative analysis of gemstone CT energy dispersive imaging can distinguish lung cancer from pulmonary tuberculosis, pneumonic mass and pulmonary tuberculosis, but the value of differential diagnosis between pneumonic mass and lung cancer needs further study and confirmation.
【作者单位】：新疆医科大学附属肿瘤医院CT室;
【基金】：新疆医科大学科研创新基金(项目编号:XYDCX201546)
【分类号】：R730.44;R734.2

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