能谱CT平扫定量分析鉴别诊断周围型肺癌与结核球

发布时间：2018-04-17 01:16

本文选题：肺肿瘤 + 结核　；参考：《中国医学影像技术》2017年08期

【摘要】：目的探讨能谱CT平扫定量分析鉴别诊断周围型肺癌和结核球的价值。方法回顾性分析于我院接受能谱CT扫描并经病理证实为单发肺结节或肿块的51例患者的资料,其中结核球15例(结核组),周围型肺癌36例(肺癌组)。分析并比较2组能谱CT平扫定量参数,包括40~140 keV单能量CT值、能谱衰减曲线类型及斜率、基物质对浓度和有效原子序数(Eff-Z)。结果肺癌组40~70 keV单能量CT值均高于结核组(P均0.05),而2组间80~140 keV单能量CT值差异均无统计学意义(P均0.05)。肺癌组平扫能谱衰减曲线类型均呈快速下降型(36/36,100%),结核组能谱衰减曲线呈平直型(11/15,73.33%)和弓背上抬型(4/15,26.67%);肺癌组40~65 keV、65~90 keV、90~140 keV平扫能谱衰减曲线斜率(K_(40~65 keV)、K_(65~90 keV)、K_(90~140 keV))均高于结核组(P均0.01)。肺癌组钙(水)浓度高于结核组(P0.01),而脂(水)浓度低于结核组(P0.01);2组水(钙)浓度差异无统计学意义(P=0.10)。肺癌组Eff-Z明显高于结核组(P0.01)。结论周围型肺癌与结核球具有不同的能谱CT定量参数指标,能谱CT平扫即可为两者的鉴别诊断提供有价值的参考信息。
[Abstract]:Objective to evaluate the value of EDS CT in differential diagnosis of peripheral lung cancer and tuberculoma.Methods the data of 51 patients with solitary pulmonary nodules or masses confirmed by pathology were retrospectively analyzed in our hospital, including 15 cases of tuberculoma (tuberculous group) and 36 cases of peripheral lung cancer (lung cancer group).The quantitative parameters of EDS CT plain scan in two groups were analyzed and compared, including 40 ~ 140 keV single energy CT value, the type and slope of energy spectrum attenuation curve, the relative concentration of base matter and the effective atomic number (Eff-Z).Results the values of 40 ~ 70 keV single energy CT in lung cancer group were higher than those in tuberculosis group (P 0.05), but there was no significant difference in 80 ~ 140 keV single energy CT value between two groups (P 0.05).In lung cancer group, the attenuation curve of plain scan energy spectrum was of a fast descending type (36 / 36100), and the attenuation curve of energy spectrum in tuberculosis group was straight (11 / 15 / 73.33) and 4 / 4 / 1526.67 / 67, respectively. The slope of energy spectrum attenuation curve of 4065 keV ~ 6590 keV ~ (90) Kev ~ (90140) keV in lung cancer group was higher than that in tuberculosis group (P = 0.01).The concentration of calcium (calcium) in lung cancer group was higher than that in tuberculosis group (P 0.01), but the concentration of lipid (water) was lower than that in tuberculosis group (P 0.01). There was no significant difference in water (calcium) concentration between two groups.Eff-Z in lung cancer group was significantly higher than that in tuberculosis group (P 0.01).Conclusion Peripheral lung cancer and tuberculoma have different quantitative parameters of EDS CT scan can provide valuable reference information for differential diagnosis.
【作者单位】：重庆医科大学附属第一医院放射科;
【基金】：国家临床重点专科建设项目(国卫办医涵[2013]544号)
【分类号】：R730.44;R734.2

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