双源CT能谱成像技术在淋巴瘤与转移性淋巴瘤鉴别诊断中的应用研究

Application values of dual-source CT spectral imaging in distinguishing the lymphoma and metastatic lymph node

目的探讨双源CT能谱成像技术对淋巴瘤与转移性淋巴瘤鉴别诊断的价值。方法回顾性分析经病理证实的35例淋巴瘤患者及30例恶性肿瘤淋巴结转移患者的双源CT动脉期及静脉期能量资料,比较两者的CT值、碘覆盖值(CTo A)、标准化平均碘浓度(NIC)、碘浓度差(IC)、碘浓度均一化比值(HRIC)及单能谱图像上淋巴结CT值差别。组间行双样本t检验分析,以P<0.05为结果具有显著性统计学差异。结果淋巴瘤组淋巴结的平扫CT值、动静脉CT值分别与平扫CT值差值均高于转移性淋巴瘤组淋巴结,3组数据差异具有统计学意义(P<0.05);淋巴瘤组动脉期及静脉期的CTo A、IC、HRIC均高于转移性淋巴瘤组,两组数据差异具有统计学意义(P<0.05),但两组NIC无显著差异(P>0.05)。淋巴瘤组淋巴结在单能量图像上CT值较转移性淋巴瘤组高,两组数据差异具有统计学意义(P<0.05)。结论双源CT能谱成像可提高淋巴瘤及转移性淋巴瘤的检出及诊断准确率,具有较大的临床价值。

Objective To explore the diagnosis and differential diagnosis values of spectral imaging of dual-source CT between lymphoma and metastatic lymph nodes（MLN）. Methods Total 35 patients with lymphoma and 30 patients with MLN,who underwent the dual-energy scans using Dual-energy computed tomography to obtain spectral serial images for arterial and portal venous phase,confirmed by pathology. The iodine map of the arterial phase and venous phase,the energy spectral curves and the mono-energetic imaging of 40-190 kev of the lymphoma and MLN were collected. The CT values,CT value of overlap（CTo A）,normalized iodine concentration（NIC）,iodine concentration（IC）,the homogenization ratio of iodine concentration ratio of lesion-normal liver（HRIC） and CT value on the single spectrum image between the arterial phase and the portal venous phase were measured. The two sample t test was performed between the arterial phase and the portal venous phase to assess the statistical differences,which was definited with P0.05. Results The lymphoma group showed higher values of the CT value of the unenhanced phase image,the difference of CT value between the arterial phase and the unenhanced phase,and between the portal venous phase and the unenhanced phase,the difference value of the CTo A,IC,HRIC both during arterial phase and the portal venous phase than MLN group（P0.05）. The lymphoma group showed higher NIC values than MLN group,but the difference was not statistically significant（P0.05）. The lymphoma group showed higher CT value on the single spectrum image than MLN group（P0.05）.Conclusion The spectral imaging of dual-source CT has great clinical value,and can improve the accuracy rate and the detection rate between lymphoma and MLN.