双能能谱CT定量检测尘肺SiO_2

Quantitative detection of SiO_2 for pneumoconiosis with dual energy spectral CT

目的应用双能能谱CT定量分析煤工尘肺病肺标本肺实质和肺结节的SiO2沉积量。方法对6个肺标本行双能能谱CT扫描,病理证实其中1个无尘肺病,1个为Ⅰ期尘肺病,1个Ⅱ期尘肺病,3个为Ⅲ期尘肺病。能谱CT扫描图像以SiO2和水为基物质对获得物质分离图像,在SiO2基图像上进行肺标本的SiO2定量。分别测量肺实质和肺结节内的SiO2沉积量并进行统计学分析。结果 5个尘肺病肺标本共检出非钙化结节68个,测量肺实质和肺结节内沉积SiO2的ROI平均分别为211.96mm2(207.17～215.46mm2)和5.74mm2(3.81～7.73mm2)。肺实质内的SiO2沉积量为11.43mg/ml(-12.07～25.87mg/ml),肺结节内SiO2的沉积量为110.16mg/ml(38.52～168.32mg/ml)。肺实质和肺结节内SiO2的沉积量差异有统计学意义(P<0.001)。另1个无尘肺病肺标本的肺实质SiO2沉积量为-8.65mg/ml(-23.31～24.62mg/ml),尘肺病肺标本与无尘肺病肺标本肺实质内SiO2沉积量差异有统计学意义(P<0.001)。结论应用双能能谱CT获得的物质分离图像可以定量肺实质和肺结节内的SiO2含量。双能能谱CT有可能为诊断和鉴别诊断尘肺病提供一种定量工具。

Objective To quantify SiO2 content in pulmonary parenchyma and nodules in pulmonary specimens of pneumoconiosis with dual energy spectral CT.Methods Six pulmonary specimens were scanned with dual energy spectral CT.There was 1 specimen of category 0,1 specimen of category Ⅰ,1 specimen of category Ⅱ and 3 specimens of category Ⅲ,pneumoconiosis confirmed by pathology.Material decomposition images with water and SiO2 as the base material pairs were obtained from the spectral CT imaging.Quantification of SiO2 in pulmonary specimens was performed on the SiO2-based images.SiO2 contents in the pulmonary parenchyma and nodules were measured and statistically compared.Results Totally 68 non-calcified nodules were detected in 5 pulmonary specimens of pneumoconiosis.The average ROI for the pulmonary parenchyma and nodules were 211.96 mm2（207.17—215.46 mm2） and 5.74 mm2（3.81—7.73 mm2）,respectively.The average SiO2 content in the pulmonary parenchyma was 11.43 mg/ml（-12.07—25.87 mg/ml）,in the pulmonary nodules was 110.16 mg/ml（38.52—168.32 mg/ml）.There was statistically significant difference for SiO2 content between pulmonary nodules and parenchyma（P0.001）.SiO2 content of the specimen with pneumoconiosis categories 0 was-8.65 mg/ml（-23.31—24.62 mg/ml）,also significantly different from that of pulmonary parenchyma specimen（P0.001）.Conclusion SiO2 content in pulmonary parenchyma and nodules can be accurately assessed using material decomposition images obtained with dual energy spectral CT,which may provide a quantitative tool for diagnosis and differential diagnosis for pneumoconiosis.