能谱CT综合分析对良恶性浆膜腔积液的鉴别价值

The value of comprehensive analysis of spectral CT in differentiating benign and malignant serous cavity effusion

目的：探讨能谱CT综合分析对良恶性浆膜腔积液的鉴别价值。方法：回顾分析2012年1月--2012年10月我院行能谱CT扫描并经组织学或生化检查证实的浆膜腔积液患者85例，其中良性浆膜腔积液14例、恶性浆膜腔积液71例。应用能谱综合分析平台，分别测量和计算各浆膜腔积液的常规混合能量CT值、不同单能量keV（40—140keV）的CT值、有效原子序数及其分布峰值、脂（水）浓度、水（碘）浓度、水（钙）浓度、能谱曲线斜率并做相应统计分析，统计比较良恶性积液的曲线类型。结果：混合能量和单能量70—120keV下CT值两组差异无统计学意义，良恶性积液在单能低keV（40～60keV）CT值有显著的统计学差异，在130。140keV两组CT值差异有统计学意义，良性积液有效原子序数及其分布峰值均高于恶性（P〈0．01），恶性组脂（水）、水（碘）、水（钙）浓度均高于良性组（P〈0．01），良性曲线斜率大于恶性（P〈0．01），良恶性积液具有不同曲线类型（P〈0．01）。结论：能谱CT综合分析平台给良恶性浆膜腔积液鉴别提供了一个多参数的方法。

Objective： To assess the value of spectral CT imaging in differentiating malignant and benign serous cavity ef- fusion on the basis of comprehensive analysis tools. Methods： Review 85 patients with histopathological or laboratory proven serous cavity effusion underwent spectral CT imaging from January 2012 to October 2012, including 14 cases of benign serous effusion and 71 cases of malignant serous effusion were reviewed. Using the spectral analysis software, the mean CT value of 140 kVp images and monochromatic images （40N140）keV, effective atomic number（eft-Z） and fat（water）, water（iodine）, water （calcium） were measured and the slope of spectral curve was measured. The differences of these spectral characteristic param- eters were evaluated statistically. The curve type of benign group and malignant group were counted respectively. Results： The CT values on 140kVp polychromatic images and 70-120 keV between benign and malignant didn＇t show any statistically sig- nificant difference. There were statistically significant differences between benign and malignant at low energy keV（40-60 keV）, and significant differences could be found at 130-140 keV. The eff-Z and the eff-Z distribution peaks of benign group were higher than that of malignancy（P〈0.01）. The fat（water）, water（iodine）, water（calcium） of malignant effusions were higher than that of benign effusion group（P〈0.01）. The slope of spectral curve of benign was higher than that of malignancy（P〈0.01）. The curve type of benign and malignant effusion could be different （P〈0.01）. Conclusion： The comprehensive analysis of the spectral CT provides a multi-parameter approach for identifying benign and malignant serous cavity effusion.