CT能谱定量分析对肺腺癌与鳞癌的鉴别诊断价值探讨

The value of CT spectral quantitative analysis in the differential diagnosis of lung adenocarcinoma and squamous cell carcinoma

目的探讨CT能谱定量分析对肺腺癌与鳞癌的鉴别诊断价值。方法选取2016年10月~2019年7月我院收治的经病理确诊且行增强CT扫描的45例患者,根据病理结果进行分组,分为肺腺癌组(n=25)、肺鳞癌组(n=20)。对所有患者于能谱CT上应用肺部GSI序列扫描,比较两组动静脉期碘含量、水含量、标准化碘含量(NIC)、能谱衰减曲线斜率K值及有效原子序数(eff-Z),并比较两组影像学表现差异。结果肺腺癌组动脉期碘含量、静脉期水含量均明显低于肺鳞癌组,而动脉期NIC明显高于肺鳞癌组,肺腺癌组eff-Z明显低于肺鳞癌组,差异有统计学意义(P<0.05);肺腺癌组动脉期70~140keV能谱衰减曲线K值均明显低于肺鳞癌组,差异有统计学意义(P<0.05);两组静脉期碘含量、动脉期水含量、静脉期NIC、静脉期70~140keV能谱衰减曲线K值比较,差异均无统计学意义(P>0.05);两组各项影像学表现中,胸膜凹陷征差异有统计学意义(P<0.05);其他影像学表现差异均无统计学意义(P>0.05)。结论CT能谱定量分析在肺腺癌与肺鳞癌的临床鉴别诊断上具有重要价值。

Objective To explore the value of computed tomography(CT)spectral quantitative analysis in the differential diagnosis of lung adenocarcinoma and squamous cell carcinoma.Methods 45 patients admitted in our hospital from October 2016 to July 2019 who were diagnosed by pathology and underwent enhanced CT scans were grouped according to the pathological results,and were divided into lung adenocarcinoma group(n=25)and lung squamous cell carcinoma group(n=20).Gemstone spectrum imagine(GSI)sequence scans of the lungs were performed on all patients on the spectral CT.The arteriovenous phase iodine content,water content,standardized iodine content(NIC),spectral attenuation curve slope K value,effective-Z(eff-Z)and the differences in imaging performance were compared between the two groups.Results The arterial iodine content and venous water content in the lung adenocarcinoma group were significantly lower than those in the lung squamous cell carcinoma group,while the arterial NIC was significantly higher than that in the lung squamous cell carcinoma group,and the eff-Z in the lung adenocarcinoma group was significantly lower than that in the lung squamous cell carcinoma group,and the differences were statistically significant(P<0.05);The K value of the 70-140keV spectrum attenuation curve in the arterial phase of the lung adenocarcinoma group was significantly lower than that of the lung squamous cell carcinoma group,and the difference was statistically significant(P<0.05).There were no significant differences in the venous iodine content,arterial water content,venous NIC,and venous 70-140keV spectrum attenuation curve K values between the two groups(P>0.05).There were significant differences in pleural depression symptoms of imaging findings between the two groups(P<0.05);There were no significant differences in other imaging findings(P>0.05).Conclusion The CT spectral quantitative analysis is of great value in the clinical differential diagnosis of lung adenocarcinoma and lung squamous cell carcinoma.