能谱CT定量分析在肺癌化疗效果评定中的应用价值

Effect value of energy spectrum CT quantitative analysis in evaluating lung cancer chemotherapy

目的分析能谱CT定量分析在肺癌化疗效果评定中的应用价值。方法收集60例肺癌化疗患者的临床资料,在化疗前后采用能谱CT进行动脉期和静脉期增强扫描,分别记录化疗前后患者的碘含量、能谱曲线斜率及水含量。结果小细胞肺癌、肺鳞状细胞癌、肺腺癌患者的治疗总有效率分别为69.23%(18/26)、66.67%(12/18)、68.75%(11/16)。化疗后,小细胞肺癌、肺鳞状细胞癌、肺腺癌患者在40~100 keV下的CT值均明显低于化疗前,差异均有统计学意义(P<0.01)。化疗后,小细胞肺癌、肺鳞状细胞癌、肺腺癌患者碘含量、水含量均低于化疗前,能谱曲线斜率均高于化疗前,差异均有统计学意义(P<0.05)。化疗后,无效组小细胞肺癌、肺鳞状细胞癌、肺腺癌患者碘基值均明显高于化疗前,有效组小细胞肺癌、肺鳞状细胞癌、肺腺癌患者碘基值均明显低于化疗前,且有效组小细胞肺癌、肺鳞状细胞癌、肺腺癌患者碘基值均明显低于无效组,差异均有统计学意义(P<0.01)。结论肺癌患者接受化疗前后采用能谱CT进行检查,有助于定量分析不同类型肺癌在化疗中的临床疗效,同时还能为后续治疗提供更为科学的影像资料。

Objective To analyze the effect value of energy spectrum CT quantitative analysis in evaluating lung cancer chemotherapy.Method Clinical data of 60 patients undergoing chemotherapy for lung cancer were collected.Energy spectrum CT for arterial phase and intravenous phase two enhanced scan before and after chemotherapy were performed,and patient’s iodine content,energy spectrum curve slope and water content before and after chemotherapy were recorded.Result The total effective rates of small cell lung cancer,lung squamous cell carcinoma and lung adenocarcinoma were 69.23%(18/26),66.67%(12/18)and 68.75%(11/16),respectively.After chemotherapy,the CT values of small cell lung cancer,lung squamous cell carcinoma and lung adenocarcinoma at 40-100 keV were significantly lower than those before chemotherapy(P<0.01);the iodine content and water content of small cell lung cancer,lung squamous cell carcinoma and lung adenocarcinoma were lower than those before chemotherapy,and the slope of energy spectrum curve were higher than those before chemotherapy(P<0.05).After chemotherapy,the iodine value of patients with small cell lung cancer,lung squamous cell carcinoma and lung adenocarcinoma in the ineffective group were significantly higher than those before chemotherapy,the effective group were lower than those before chemotherapy,and the values in the effective group were significantly lower than those in the ineffective group(P<0.01).Conclusion Energy spectrum CT in lung cancer patients before and after chemotherapy is helpful to quantitatively analyze the clinical efficacy of different types of lung cancer in chemotherapy,which can also provide more scientific imaging data for subsequent treatment.