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宝石能谱CT鉴别诊断孤立性肺结节或肿块的应用价值

发布时间:2018-06-21 05:22

  本文选题:肺肿瘤 + 肺炎性病变 ; 参考:《新疆医科大学》2017年硕士论文


【摘要】:目的:探讨宝石能谱CT成像定量分析功能在鉴别诊断肺癌、肺炎性病变和肺结核中的价值。方法:收集经能谱CT增强扫描的78例肺结节或肿块患者,根据病理及治疗后随访结果分为肺癌组(38例)、肺结核组(20例)及肺炎性病变组(20例),分别测量动、静脉期病灶周围区的40-100keV区间间隔为10的单能量CT值、碘浓度(IC)、水浓度(WC)及能谱曲线斜率,并测量肺炎性病变和肺癌组病灶中央区的碘浓度,同时测量同层面胸主动脉或锁骨下动脉的碘浓度及水浓度,并计算病灶的标准化碘浓度(NIC)及标准化水浓度(NWC),同时计算病灶中央区与周围区标准化碘浓度之差的绝对值(dNIC)。三组间各参数的差异性比较采用方差分析或秩和检验,两组间差异性比较采用t检验。绘制ROC曲线,确定各能谱参数鉴别诊断三组病变的临界值及其诊断效能。结果:三组病变间的动、静脉期病灶周围区单能量CT值(40-100e V)、IC、NIC及λHU差异均有统计学意义(P0.05)。三组间WC及NWC差异无统计学意义(P0.05)。两两比较结果为肺炎性病变和结核组、肺癌组和结核组间差异均有统计意义(P0.05),而肺炎性病变和肺癌组间差异无统计学意义(P0.05)。肺炎组和肺癌组间中央区IC、NIC及周围区与中央区NIC的差值(dNIC=NICper-NICce n)比较差异有统计学意义(P0.05)。静脉期NIC=0.325、0.297时,鉴别诊断肺炎性病变与肺结核、肺癌与肺结核的灵敏度分别为95%、97%,特异度分别为85%、75%。动脉期病灶中央区NIC=0.062时,鉴别肺癌与肺炎性病变的灵敏度和特异度分别是95%、79%。结论:宝石能谱CT的多参数定量分析功能可以用于肺癌、肺结核及肺炎性病变的鉴别诊断。
[Abstract]:Objective: to evaluate the value of quantitative analysis of gemstone energy dispersive CT imaging in differential diagnosis of lung cancer, pneumonia and pulmonary tuberculosis. Methods: Seventy-eight patients with pulmonary nodules or masses who were examined by EDS CT were divided into lung cancer group (n = 38) and pulmonary tuberculosis group (n = 20) and pneumonitis group (n = 20). The single energy CT value, iodine concentration, water concentration and WCC) and the slope of the energy spectrum curve were measured at 40-100keV interval of 10 in the perifocal area of venous phase. The iodine concentration in the central area of the lesion was measured in the patients with pneumonitis and lung cancer. The iodine concentration and water concentration of thoracic aorta or subclavian artery were measured at the same time. The standardized iodine concentration (NICs) and the standard water concentration (NWCU) of the lesion were calculated. The absolute value of the difference of the standardized iodine concentration between the central area of the lesion and the surrounding area was calculated. Analysis of variance or rank sum test were used to compare the differences between the three groups, and t test was used to compare the differences between the two groups. The ROC curve was drawn to determine the critical value and diagnostic efficacy of each energy spectrum parameter for differential diagnosis of three groups of lesions. Results: there were significant differences in ICNIC and 位 Hu between the three groups (P 0.05). There was no significant difference in WC and NWC among the three groups (P 0.05). The difference between lung cancer group and tuberculosis group was significant (P 0.05), but there was no significant difference between lung cancer group and lung cancer group (P 0.05). The difference of Nic in central and peripheral areas between pneumonia group and lung cancer group was statistically significant (P 0.05). The sensitivity of lung cancer and pulmonary tuberculosis was 95 / 97, and the specificity was 8575 / 7575, respectively. The sensitivity and specificity in differentiating lung cancer from pneumonic lesions were 95% and 79% respectively. Conclusion: multiparameter quantitative analysis of gemstone energy dispersive CT can be used in differential diagnosis of lung cancer, pulmonary tuberculosis and pneumonitis.
【学位授予单位】:新疆医科大学
【学位级别】:硕士
【学位授予年份】:2017
【分类号】:R563;R816.41

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