能谱CT在孤立肺结节鉴别诊断中的应用价值

THE VALUE OF ENERGY SPECTRUM CT IN THE DIFFERENTIAL DIAGNOSIS OF SOLITARY PULMONARY NODULES

目的探讨能谱CT在孤立肺结节良恶性质鉴别诊断中的应用价值。方法选取2018年7月—2019年7月于唐山市人民医院行能谱CT检查且经病理证实的101例肺部结节(不含结核)患者,其中良性39例,恶性62例。所有患者行能谱CT增强扫描,比较二组动脉期不同keV下的CT值、能谱曲线斜率、碘浓度、水浓度、有效原子序数等能谱参数,分析不同性质孤立肺结节的能谱影像特征。结果良性组在40keV、100 keV能量水平下动脉期单能量CT值均高于恶性组,差异均有统计学意义(均P<0.05);良性组40~100keV段动脉期能谱曲线斜率明显高于恶性组,差异有统计学意义(P<0.05)。良性组动脉期碘浓度、水浓度、有效原子序数均大于恶性组。其中,良性组碘浓度显著大于恶性组,差异有统计学意义(P<0.05);良性组动脉期水浓度、有效原子序数与恶性组比较差别不大,差异均无统计学意义(均P>0.05)。结论能谱CT对孤立肺结节的鉴别诊断有一定应用价值。

Objective To explore the value of energy spectrum CT in differential diagnosis of benign and malignant solitary pulmonary nodules.Methods From July 2018 to July 2019,one hundred and one cases of pulmonary nodules(not including tuberculosis)confirmed by pathology and examined by energy spectrum CT in Tangshan People’s Hospital were selected,including 39 cases of benign nodules and 62 cases of malignant nodules.All patients received enhanced energy spectrum CT scan,and compared the CT value,energy spectrum curve slope,iodine concentration,water concentration,effective atomic number and other energy spectrum parameters of the two groups under different keV at arterial phase,to analyze the energy spectrum image characteristics of isolated pulmonary nodules with different properties.Results At 40 keV and 100 keV energy levels,CT values of arterial phase were higher in the benign group than in the malignant group,and the difference was statistically significant(P<0.05).The slope of the energy spectrum curve at 40-100 keV arterial phase in the benign group was significantly higher than that in the malignant group,and the difference was statistically significant(P<0.05).The iodine concentration,water concentration and effective atomic number in the benign group were all higher than those in the malignant group.The iodine concentration in the benign group was significantly higher than that in the malignant group,and the difference was statistically significant(P<0.05).There were no significant differences in arterial water concentration and effective atomic number between the benign group and the malignant group(P>0.05).Conclusion Energy spectrum CT has a certain value in the differential diagnosis of solitary pulmonary nodules.