能谱CT成像参数在非实性肺结节空气支气管征中的价值

Value of Energy Spectral CT Imaging Parameters in Non-Solid Pulmonary Nodules with Air Bronchograms

目的:探究能谱CT成像定量参数在非实性肺结节空气支气管征中的价值。方法:回顾性分析我院2019年7月—2021年3月收治的264例经手术切除并被证实为肺腺癌的非实性肺结节(270个)患者,其中82个病灶出现空气支气管征,再根据其支气管走行进行分类。最后分别记录其结节最大径、浸润程度、动静脉期的能谱参数,并进行统计学分析。采用ROC曲线分析各参数预测空气支气管征分型的诊断效能。结果:82个出现空气支气管征的病灶中,27个病灶内支气管管腔走行正常(正常型),55个支气管管腔扩张、走行扭曲或闭塞(异常型)。肺腺癌的浸润程度在正常型与异常型空气支气管征之间存在显著差异(P<0.05)。动脉期碘含量(IC)值、动脉期及静脉期标准化碘含量(NIC)值、结节最大径在2组空气支气管征分型中出现显著差异(P<0.05)。动脉期IC值、动脉期及静脉期NIC值在2组空气支气管征中均具有良好的诊断效能,ROC曲线下面积分别为0.735、0.728和0.679。结论:能谱CT成像参数在不同空气支气管征分型结节中具有显著差异性;异常空气支气管征还可以提示病灶的浸润性,更有助于诊断非实性肺结节。

Purpose:To explore the value of energy spectral CT imaging quantitative parameters in evaluation of air bronchograms of non-solid pulmonary nodules.Methods:A retrospective analysis was performed in 264 patients with 270 non-solid nodules confirmed as lung adenocarcinomas from July 2019 to March 2021 in our hospital.There were 82 lesions with air bronchograms,and they were classified according to their bronchial shape.Finally,the maximum diameter of the lesion,the degree of infiltration,and the energy spectral parameters of the arteriovenous phase were recorded and analyzed.The chi-square test was used to compare the differences of air bronchograms and lung adenocarcinoma nodule infiltration between the two groups;and the independent sample t-test was used to compare the differences in the maximum diameter of the lesions and the energy spectral parameters of the arteriovenous phase between the two groups.The ROC curve analysis was used to evaluate each parameter in predicting the diagnostic efficacy of air bronchograms classification.Results:Eighty-two out of 270 lung adenocarcinoma nodules were with air bronchograms.Among them,the bronchial lumen in 27 lesions was normal(normal type),and the bronchial lumen in 55 lesions was dilated,twisted or occluded(abnormal type).There was a significant difference in invasiveness of lung adenocarcinoma between the normal type and abnormal type of air bronchograms(P<0.05).There were significant differences in the arterial-phase IC value,arterial-and venous-phase NIC value,and the maximum diameter of nodules between the two groups of air bronchograms(P<0.05).The arterial-phase IC value and the arterial-and venous-phase NIC value had good diagnostic performance in the two groups of air bronchograms with the AUC value of 0.735,0.728,and 0.679,respectively.Conclusion:Energy spectral CT imaging parameters showed significant differences in different air bronchogram nodules.Abnormal type of air bronchograms can also indicate the infiltration of the lesion.This allows us to have a deeper understanding of air bronchograms.It is more helpful to diagnose non-solid pulmonary nodules.