能谱CT对孤立性肺结节的鉴别诊断价值分析

Analysis of Differential Diagnosis Value of Spectral CT in Solitary Pulmonary Nodule

目的:分析能谱CT对孤立性肺结节(SPN)的鉴别诊断价值。方法:回顾性分析2020年6月—2022年6月厦门市第五医院收治的并经病理学证实的75例SPN患者的临床资料,根据病理分型将患者分为恶性组(n=35)和良性组(n=40),两组均行能谱CT扫描。比较两组碘含量(IC1es)、标准化碘浓度(NIC)、标准化碘浓度之差(ICD)、水含量(WC1es)、标准化水浓度(NWC)、标准化水浓度之差(WCD)、单能量(40 keV、70 keV、100 keV、140 keV)及能谱曲线斜率(40~70 keV、71~100 keV、101~140 keV)。结果:恶性组动脉期和静脉期的IC1es、NIC及ICD高于良性组,差异有统计学意义(P<0.05);恶性组动脉期和静脉期的40 keV、70 keV、100 keV、140 keV单能量水平CT值均高于良性组,差异有统计学意义(P<0.05);恶性组动脉期和静脉期的40~70 keV、71~100 keV区间倾斜率高于良性组,差异有统计学意义(P<0.05)。结论:能谱CT可鉴别诊断良恶性SPN,为临床治疗提供依据。

Objective:To analyze the differential diagnosis value of spectral CT in solitary pulmonary nodule(SPN).Method:Clinical data of 60 patients with SPN verified by pathology who treated in the Fifth Hospital of Xiamen from June 2020 to June 2022 were retrospectively analyzed,the patients were divided into malignant group(n=35)and benign group(n=40)according to the pathological type,all patients were completed spectral CT scanning.The iodine concentration(IC1es),normalized iodine concentration(NIC),normalized iodine concentration difference(ICD),water concentration(WC1es),normalized water concentration(NWC),normalized water concentration difference(WCD),single energy(40 keV,70 keV,100 keV,140 keV)and slopes of energy spectral curves(40-70 keV,71-100 keV,101-140 keV)were compared between two groups.Result:The IC1es,NIC and ICD of malignant group in arterial and venous phases were higher than those of benign group,the differences were statistically significant(P<0.05).The CT values at 40 keV,70 keV,100 keV and 140 keV single energy levels of malignant group in arterial and venous phases were higher than those of benign group,the differences were statistically significant(P<0.05).The 40-70 keV and 71-100 keV interval slopes of malignant group in arterial and venous phases were higher than those of benign group,the differences were statistically significant(P<0.05).Conclusion:Spectral CT can be used to differentiate benign and malignant SPN,which provides a basis for clinical treatment.