能谱CT定量指标在鉴别诊断非小细胞肺癌转移淋巴结与非转移淋巴结中的价值

Differentiating Metastatic Lymph Nodes from Non-Metastatic Lymph Nodes in Non-SmallCell Lung Cancer: the Value of Spectral CT Quantitative Indicators

【目的】评估能谱CT定量指标鉴别诊断非小细胞肺癌(NSCLC)转移淋巴结与非转移淋巴结的价值。【方法】对48例非小细胞肺癌转移淋巴结(n=34)与非转移淋巴结(n=40)的CT平扫、动脉期及静脉期能谱定量指标进行比较。【结果】转移淋巴结平扫及动脉期碘基物质密度、平扫及动脉期有效原子序数、平扫及动脉期标化有效原子序数、动脉期标化碘基物质密度均低于非转移淋巴结组,差异均具有统计学意义(P<0.05),依据动脉期标化有效原子序数<0.7278,诊断淋巴结为恶性的正确几率分别为83.3%。依据动脉期标化碘基物质密度>0.1574,诊断淋巴结为良性的正确几率分别为86.7%。【结论】能谱CT定量指标对鉴别诊断非小细胞肺癌转移淋巴结与非转移淋巴结提供定量分析,提高非小细胞肺癌的淋巴结分期。

[Objectives] To evaluate the value of spectral CT quantitative indicators in the differential diagnosis of metastatic and non-metastatic lymph node in NSCLC.[Methods] 48 patients with NSCLC were enrolled including metastatic lymph nodes group （n=34） and non-metastatic lymph nodes group （n =40）.Unenhanced,arterial phase and venous phase enhanced spectral CT quantitative indicators were compared between metastatic and non-metastatic lymph nodes.[Results] Iodine Concentrations,effective Z value,normalized effective Z value of metastatic lymph node group were statistically lower than that of non-metastatic lymph node group both in unenhanced phase and in arterial phase,same result was found as well as normalized Iodine Concentrations in arterial phase （P ＜ 0.05）.The accuracy of using normalized effective Z value in arterial phase ＜ 0.7278 as criteria to get a diagnosis of metastatic lymph node was 83.3％.The accuracy of using normalized Iodine Concentrations in arterial phase ＞ 0.1574 as criteria to get a diagnosis of non-metastatic lymph node was 86.7％.[Conclusions] Spectral CT quantitative indicators can provide quantitative analysis in differential diagnosis of metastatic and non-metastatic lymph node in NSCLC,and improving the diagnostic accuracy of N staging of NSCLC.