宝石能谱CT在胸部肿瘤病变诊断中的价值初探

发布时间：2018-06-03 04:50

本文选题：体层摄影术 + X线计算机　；参考：《北京协和医学院》2017年硕士论文

【摘要】：第一部分宝石能谱CT在NSCLC转移灶探查中的应用价值[目的]宝石能谱CT在NSCLC转移灶探查中的应用价值。[材料与方法]前瞻性分析30例NSCLC患者共70个转移灶(包括肺、胸膜、肾上腺、肝脏、骨骼及腰大肌等)的能谱参数,包括不同keV条件下的能谱曲线斜率,碘、水基物质浓度值,并进行统计学分析。[结果]本研究选取并计算λ40-100keV、λ40-110keV、...至λ60-140keV共15条能谱曲线斜率,其中λ40-100keV、λ40-110keV、...至λ50-140keV共10条原发灶与转移灶能谱曲线斜率相关性较好,相关系数r值为0.502(P0.05);原发灶与肺、胸膜转移灶能谱曲线斜率(λ40-100keV、λ40-110keV、λ40-120keV)相关性更好,相关系数r值为0.692(P0.05);原发灶与转移灶的碘浓度值相关系数为0.504(P0.05);原发灶与肺、胸膜转移灶的碘浓度值相关性更好,r值为0.693(P0.05)。原发灶与转移灶水浓度值相关性无统计学意义(P0.05)。[结论]宝石CT能谱曲线斜率和碘浓度值可用于NSCLC患者转移灶的探查,评价效能受转移部位影响。第二部分宝石能谱CT在胸膜原发肿瘤诊断中的价值初探[目的]探讨宝石能谱CT在胸膜原发肿瘤术前诊断中的应用价值。[材料与方法]回顾性分析19例胸膜原发肿瘤患者的临床病历资料、CT图像特征和能谱参数,包括不同keV水平下的CT值,碘、水浓度及良恶性病变的能谱曲线斜率等,并进行统计学分析。[结果]恶性病变8例:恶性胸膜孤立性纤维性肿瘤(SFTP)3例,胸膜间皮瘤3例,滑膜肉瘤2例;良性病变11例:神经鞘瘤9例,良性SFTP1例,脂肪瘤1例。恶性与良性肿瘤(除外脂肪瘤)能谱参数比较,恶性肿瘤平均碘浓度及平均水浓度为(14.05±8.82)g/L、(1027.32±8.64),良性肿瘤平均碘浓度及平均水浓度为(6.38±5.33)g/L、(1016.44±11.94);恶性肿瘤能谱曲线斜率为(1.40±0.70),良性肿瘤能谱曲线斜率为(0.85±0.54);40～110keV条件下恶性肿瘤CT值明显大于良性肿瘤,且差异具有统计学意义(P0.05)。[结论]不同病理类型的胸膜原发肿瘤具有一定的能谱CT特征,CT图像和能谱参数的结合对胸膜原发肿瘤良恶性的判断具有一定的价值。
[Abstract]:Application value of gemstone spectrum CT in NSCLC metastasis [objective] to evaluate the value of gemstone spectrum CT in the exploration of NSCLC metastatic foci. [materials and methods] the energy spectrum parameters of 70 metastatic foci (including lung, pleura, adrenal gland, liver, bone and psoas major muscle) in 30 patients with NSCLC were analyzed prospectively, including the slope of energy spectrum curve and iodine under different keV conditions. Water-based substance concentration, and statistical analysis. [results] 位 40-100 Kev, 位 40-110 Kev were selected and calculated in this study. To 位 60-140keV, there are 15 slopes of energy spectrum curves, including 位 40-100keV, 位 40-110keV. There was a good correlation between the slope of energy spectrum curve of 10 primary lesions and metastatic foci to 位 50-140keV, the correlation coefficient r value was 0.502mP0.050.The slope of energy spectrum curve between primary focus and lung was better than that between primary focus and lung (位 40-100keV, 位 40-110keV, 位 40-120keV), and there was a better correlation between the slope of the spectrum curve between the primary focus and the metastatic focus (位 40-100keV, 位 40-110keV, 位 40-120keV). The correlation coefficient (r) was 0. 692 渭 m P0.05, the correlation coefficient of iodine concentration between primary tumor and metastatic focus was 0. 504 (P 0. 05), and the correlation between primary tumor and lung, pleural metastasis was better than that between primary tumor and lung, and the correlation of iodine concentration between primary tumor and metastatic focus was 0. 693% (P 0. 05). There was no significant correlation between primary focus and water concentration of metastatic foci (P 0.05). [conclusion] the slope of gem CT energy spectrum curve and iodine concentration can be used in the exploration of metastatic foci in NSCLC patients, and the evaluation effectiveness is affected by metastasis site. Part II value of gemstone spectroscopic CT in the diagnosis of pleural primary tumors [objective] to explore the value of gemstone spectrum CT in preoperative diagnosis of pleural primary tumors. [materials and methods] the clinical data of 19 patients with pleural primary tumor were retrospectively analyzed, including CT value of different keV levels, iodine, water concentration and slope of energy spectrum curve of benign and malignant lesions. Statistical analysis was carried out. [results] 8 cases of malignant lesions: 3 cases of malignant pleural solitary fibrous tumor, 3 cases of pleural mesothelioma, 2 cases of synovial sarcoma, 11 cases of benign lesions: 9 cases of neurilemmoma, 9 cases of benign SFTP1, 1 case of lipoma. Comparison of energy spectrum parameters between malignant and benign tumors (excluding lipomas), The mean iodine concentration and average water concentration of malignant tumor were 14.05 卤8.82 g / L ~ (-1) 卤8.64 渭 m, the mean iodine concentration and water concentration of benign tumor were 6.38 卤5.33 g / L ~ (-1) and 1016.44 卤11.94% respectively, the slope of energy spectrum curve of malignant tumor was 1.40 卤0.70, the slope of energy spectrum curve of benign tumor was 0.85 卤0.54 ~ (40) ~ (110) Kev, the CT value of malignant tumor was significantly higher than that of benign tumor. The difference was statistically significant (P 0.05). [conclusion] different pathological types of primary pleural tumors have certain spectral CT features. The combination of CT images and energy spectrum parameters is valuable for the diagnosis of benign and malignant pleural primary tumors.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R730.44

【相似文献】