双能量CT成像鉴别诊断颈部鳞癌转移淋巴结与淋巴结结核

发布时间：2018-06-13 23:46

本文选题：头颈部肿瘤 + 癌　；参考：《中国医学影像学杂志》2015年03期

【摘要】：目的探讨双源CT双能量成像技术在颈部鳞癌转移淋巴结与淋巴结结核鉴别诊断中的价值。资料与方法选取经病理证实为颈部鳞癌转移淋巴结、淋巴结结核的25例患者,共62枚颈部肿大淋巴结,均行双能量动脉期增强扫描。测量两种不同病理性质淋巴结实质碘覆盖值,观察能谱曲线变化趋势并比较两种不同病理性质淋巴结能谱曲线斜率,分析碘覆盖值和能谱曲线的斜率鉴别两种病变的诊断敏感度和特异度。结果 62枚淋巴结中,鳞癌转移性淋巴结32枚,淋巴结结核30枚。鳞癌转移淋巴结的碘覆盖平均值、曲线平均斜率与淋巴结结核比较,差异有统计学意义(t=3.806、3.698,P0.05)。在60~180 ke V范围内,随着单能ke V值的升高,鳞癌转移淋巴结与淋巴结结核CT值逐渐递减,且ke V值越高,CT值降低的幅度越小,其能谱曲线在60~180 ke V下均呈下降型。碘覆盖值曲线下面积为0.756,对鉴别两种病变的诊断敏感度为56%,特异度为80%;能谱曲线的斜率曲线下面积为0.898,对鉴别两种病变的诊断敏感度为76%,特异度为85%。结论动脉期碘覆盖值及能谱曲线斜率对颈部鳞癌转移淋巴结与淋巴结结核的影像鉴别诊断均有一定的意义,且能谱曲线斜率对其鉴别诊断优于碘覆盖值。
[Abstract]:Objective to evaluate the value of dual-source CT dual-energy imaging in differential diagnosis of metastatic lymph nodes and lymph node tuberculosis in cervical squamous cell carcinoma. Materials and methods Sixty-two cervical enlarged lymph nodes were selected from 25 patients with metastatic lymph nodes and tuberculosis of lymph nodes confirmed by pathology. The iodine coverage values of two different pathological lymph nodes were measured, and the tendency of energy spectrum curve was observed and the slope of the spectrum curves of two kinds of pathological lymph nodes were compared. The diagnostic sensitivity and specificity of iodine coverage value and slope of energy spectrum curve were analyzed. Results there were 32 metastatic lymph nodes and 30 tuberculous lymph nodes in squamous cell carcinoma. The average value of iodine coverage and the mean slope of the curve in metastatic lymph nodes of squamous cell carcinoma were significantly different from those of lymph node tuberculosis (P 0.05). In the range of 60,180keV, the CT value of metastatic lymph node and lymph node tuberculosis of squamous cell carcinoma decreased gradually with the increase of monoenergy value. The higher the value of ke V was, the smaller the decrease of CT value was, and the energy spectrum curve of SCC decreased at 60,180keV. The area under the iodine coverage curve was 0.756, the diagnostic sensitivity and specificity of the two kinds of lesions were 56 and 80 respectively, the area under the slope curve of the energy spectrum curve was 0.898, and the sensitivity and specificity for the diagnosis of the two kinds of lesions were 76 and 85, respectively. Conclusion the iodine coverage value and the slope of the energy spectrum curve in arterial phase have some significance for the differential diagnosis of metastatic lymph nodes and lymph node tuberculosis in cervical squamous cell carcinoma, and the slope of the energy spectrum curve is superior to the iodine cover value in the differential diagnosis of cervical squamous cell carcinoma.
【作者单位】：昆明医科大学第一附属医院医学影像科;
【基金】：云南省卫生科技计划项目(2014NS158)
【分类号】：R739.91;R730.44

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