能谱CT在肺癌淋巴结转移诊断中的临床应用研究

Applications of Gemstone Spectrum CT in the Diagnosis of Metastatic Lymph Nodes in Lung Cancer

[目的]通过对小细胞肺癌和鳞癌进行能谱增强扫描,探讨肺癌与转移性淋巴结能谱参数之间的关系。[方法]经病理证实的24例伴有纵隔转移淋巴结的小细胞肺癌患者和14例伴有纵隔反应增生性淋巴结的鳞癌患者,在能谱CT上行能谱增强扫描,获得单能量图像。再对单能量图像进行分析,通过能谱曲线、碘含量、有效原子序数等能谱参数分析,然后将结果进行对比分析。[结果]小细胞肺癌与其相应的转移性淋巴结能谱曲线重合性良好,前两者与反应增生性淋巴结的能谱曲线有较大差别。小细胞肺癌、转移性淋巴结、反应增生性淋巴结三组之间的碘含量、有效原子序数均具有统计学差异(F=10.226,P=0.000;F=10.281,P=0.000)。反应增生性淋巴结与小细胞肺癌的能谱数据差异有统计学意义(P=0.000)。反应增生性淋巴结与转移性淋巴结的能谱数据差异有统计学意义(P=0.000)。[结论]CT能谱成像在一定程度上可以有效地反映出肺癌转移性淋巴结与原发肺癌之间具有组织同源性,对肿瘤的诊断与鉴别诊断可以提供帮助。

[Objective] To evaluate the diagnosis of gemstone spectral imaging（GSI） of metastatic lymph nodes in lung cancer with Discovery CT750 HD.[Methods] GSI of 24 small cell lung cancer（SCLC） patients with mediastinal lymph nodes and 14 squamous cell carcinoma with reactive hyperplastic lymph nodes confirmed by pathology or follow-up data were collected.Enhanced scans were performed with Discovery CT750 HD.The differences of spectrum curves,spectrum curves slopes,iodine content,effective Z value between SCLC,mediastinal lymph nodes and reactive hyperplastic lymph nodes were analyzed.[Results] Spectrum curves of SCLC and mediastinal lymph nodes matched good.There was a big difference between reactive hyperplastic lymph nodes and other two groups.The iodine content and effective Z value of three groups had a statistically significant（F=10.226,P=0.000;F=10.281,P=0.000）.There was a statistically significant between reactive hyperplastic lymph nodes and mediastinal lymph nodes（P=0.000）,as well as reactive hyperplastic lymph nodes and SCLC（P=0.000）.[Conclusion] Enhanced scan of spectral CT demonstrates the potential in diagnosing metastatic mediastinal lymph nodes in lung cancer.