周围型肺腺癌和周围型肺鳞癌的能谱CT表现

Spectral CT findings of peripheral lung adenocarcinoma and peripheral lung squamous cell carcinoma

目的:观察周围型肺腺癌和周围型肺鳞癌的能谱CT表现。方法:回顾性分析经病理证实并行能谱CT扫描的周围型肺腺癌122例和周围型肺鳞癌89例。测量病灶在动脉期及静脉期下的CT_(40 keV)值、CT_(70 keV)值、CT_(100 keV)值、碘(水)浓度(IC)、水(碘)浓度(WC)和有效原子序数(Zeff),并计算能谱曲线斜率(K_(70 keV))。比较两组之间各能谱参数之间的差异。结果:两组之间性别差异有统计学意义(P<0.05),而其他临床特征和临床症状在两组之间差异无统计学意义(P>0.05)。动脉期和静脉期,周围型肺腺癌的CT_(40 keV)、CT_(70 keV)、K_(70 keV)、IC及Zeff均大于周围型肺鳞癌,差异具有统计学意义(P<0.05);而两组之间的WC和CT_(100 keV)无统计学意义(P>0.05)。ROC曲线分析显示,动脉期各定量参数联合较静脉期各定量参数联合的诊断效能好,曲线下面积、敏感性和特异性分别为86%、77%、83%。结论:周围型腺癌和周围型鳞癌的能谱CT表现存在一定差异,可为二者的鉴别提供参考。

Objective To compare the spectral computed tomography(CT)findings of peripheral lung adenocarcinoma versus peripheral lung squamous cell carcinoma.Methods A total of 122 cases of peripheral lung adenocarcinoma and 89 cases of peripheral lung squamous cell carcinoma were analyzed retrospectively.All of these cases were proved by pathology and received energy spectral CT examination.The CT_(40 keV),CT_(70 keV),CT_(100 keV),iodine(water)concentration(IC),water(iodine)concentration(WC)and effective atomic number(Zeff)were measured in the arterial phase and the venous phase,and the slope of spectral curve(K_(70 keV))was calculated.The differences of spectral parameters between two groups were compared.Results There was no significant difference between two groups in clinical features and symptoms(P>0.05)except gender(P<0.05).In the arterial phase and the venous phase,the CT_(40 keV),CT_(70 keV),K_(70 keV),IC and Zeff of peripheral lung adenocarcinoma were higher than those of peripheral lung squamous cell carcinoma,with statistical differences(P<0.05),but no significant difference was found in WC and CT_(100 keV) between two groups(P>0.05).Receiver operating characteristic curve analysis showed that the combination of quantitative parameters in the arterial phase had better diagnostic efficiency than the combination of quantitative parameters in the venous phase,and that the area under the curve,sensitivity and specificity of the former were 86%,77%,and 83%,respectively.Conclusion There are some differences in spectral CT findings between peripheral lung adenocarcinoma and peripheral lung squamous cell carcinoma,which can provide reference for the differential diagnosis.