双源CT双能量成像在孤立性肺肿块的诊断价值

发布时间：2018-05-23 19:21

  本文选题：肺肿瘤 + 双能量成像　； 参考：《临床放射学杂志》2015年08期

【摘要】：目的探讨双源CT(DSCT)双能量成像技术在孤立性肺肿块诊断中的价值。方法对67例肺内孤立性肿块(恶性肿瘤48例,良性肿块19例)行DSCT常规增强及双能增强扫描,获得肿块动、静脉期常规增强与虚拟平扫及碘基图CT值、40~190 keV系列单能量图像CT值,并记录各肿块动、静脉期碘含量,计算动、静脉肿块能谱曲线斜率。利用F检验、t检验或ROC曲线对比分析能谱曲线、碘含量及碘基图CT值。结果动脉期肿块增强CT值与碘基图CT值差异无统计学意义(P0.05),动脉期增强图像与碘基图CT值显示高度一致性,相关系数r=0.89;静脉期肿块增强CT值与碘基图CT值差异有统计学意义(P0.05)。动脉期在40~100 keV区间下肺恶性肿瘤、炎性肿块及结核瘤的CT值两两之间差异均有统计学意义(P0.05);静脉期在40~110 keV下肺恶性肿瘤、炎性肿块及结核瘤的CT值两两之间差异均有统计学意义(P0.05)。以CT值18 HU作为肿块良恶性诊断阈值(18 HU为良性,≥18 HU为恶性),碘基图CT值诊断孤立性肺肿块良恶性的敏感性为83.3%,特异性为76.2%,准确性为81.2%。动、静脉期恶性肿瘤、炎性肿块及结核球的碘含量均值分别为(1.00±0.07)mg/ml、(1.92±0.12)mg/ml、(0.46±0.05)mg/ml和(1.25±0.14)mg/ml、(2.06±0.18)mg/ml及(0.58±0.06)mg/ml;能谱曲线斜率均值分别为-0.96、-1.38、-1.97和-2.27、-0.45、-0.56,两期恶性肿瘤与炎性肿块、炎性肿块与结核球、恶性肿瘤与结核球间碘含量及能谱曲线斜率差异均有统计学意义(P均0.05)。结论采用DSCT双能量成像的参数进行定量分析,对孤立性肺肿块的良恶性鉴别诊断有较大价值。
[Abstract]:Objective to evaluate the diagnostic value of dual source CT DSCT imaging in solitary pulmonary masses. Methods 67 cases of solitary pulmonary mass (malignant tumor 48 cases, benign tumor 19 cases) were examined by conventional and dual enhanced DSCT. The conventional contrast enhancement, virtual plain scan and CT value of 40 ~ 190 keV series of single energy images were obtained in arteriovenous phase. The iodine content of each tumor was recorded and the slope of energy spectrum curve was calculated. Energy spectrum curve, iodine content and CT value of iodine base map were analyzed by F test or ROC curve. Results there was no significant difference between the enhancement CT value of arterial mass and the CT value of iodide radiography (P 0.05). The CT value of arterial phase enhancement was highly consistent with the CT value of iodide base image, the correlation coefficient was 0.89, and the CT value of venous mass was significantly different from that of iodide base image (P 0.05). The CT values of pulmonary malignant tumors, inflammatory masses and tuberculoma in arterial phase were significantly different between 40 ~ 100 keV and 40 ~ 110 keV, respectively. The CT values of inflammatory masses and tuberculoma were significantly different (P 0.05). Using 18 Hu as the diagnostic threshold for benign and malignant tumors and 鈮，

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