能谱CT对肺部磨玻璃样结节良恶性鉴别诊断的价值

The Value of Energy Spectrum CT in the Differential Diagnosis of Benign and Malignant Pulmonary Ground Vitreous Nodules

目的:探究在肺部磨玻璃样结节良恶性鉴别诊断中能谱CT的临床应用价值。方法:取40例于2019年1月~2019年6月在某院做能谱CT检查的肺部磨玻璃样结节患者,通过对患者的临床资料进行回顾分析,所有患者均属于单发性结节,恶性磨玻璃样结节13例,良性非结核性磨玻璃结节13例,结核性磨玻璃结节14例,分别作为恶性组(n=13)、良性非结核组(n=13)、结核组(n=14)。全部病例中23例行外科切除后病理证实,17例介入微创术穿刺活检证实。结果:恶性组及结核组的平扫40~140KeV下的CT值高于良性结节组,有统计学差异(P<0.05);恶性组和良性非结核组的碘含量明显高于结核结节组,有统计学差异(P<0.05);恶性组和结核结节组在平扫及增强后能谱曲线斜率大于良性非结核组,有统计学差异(P<0.05);3组的标准碘含量及结节水含量之间无明显差异(P>0.05)。结论:在肺部磨玻璃样结节良恶性鉴别诊断中应用能谱CT,为临床诊断提供了重要参考价值。

Objective:To explore the clinical value of energy spectrum CT in the differential diagnosis of pulmonary ground vitreous nodules.Methods:From January 2019 to June 2019,40 patients with pulmonary ground vitreous nodules were examined in a hospital by energy spectrum CT,and the clinical data of the patients were retrospectively analyzed.All patients were single-scalated nodules,including 13 cases of malignant ground vitreous nodules(malignant group,n=13),13 cases of benign non-tuberculosis ground vitreous nodules(benign non-tuberculosis group,n=13),and 14 cases of tuberculous ground vitreous nodules(tuberculosis group,n=14).In all cases,23 cases were confirmed by pathology after surgical resection and 17 cases were confirmed by interventional minimally invasive biopsy.Results:The CT value of plain scan 40~140 KeV in malignant group and tuberculosis group was higher than that in benign nodule group,with statistical difference(P<0.05).Iodine content in malignant group and benign non-tuberculosis group was significantly higher than that in tuberculous nodule group,with statistical difference(P<0.05).After plain scan and enhancement,the slope of energy spectrum curve in malignant group and tuberculous nodule group was larger than that in benign non-tuberculosis group,with statistical difference(P<0.05).there was no significant difference in the standard iodine content and nodular water content among the three groups(P>0.05).Conclusion:The application of energy spectrum CT in the diagnosis of benign and malignant lesions of the pulmonary ground vitreous nodules is of great reference value for clinical diagnosis.