能谱CT定量在肺腺癌与鳞癌鉴别诊断中的价值

Value of Spectral CT Quantification in the Differential Diagnosis of Lung Adenocarcinoma and Squamous Cell Carcinoma

目的探讨能谱计算机断层扫描成像(CT)定量在肺腺癌与鳞癌鉴别诊断中的价值。方法回顾性选取2018年3月-2021年5月收治的58例肺腺癌患者(腺癌组)和42例肺鳞癌患者(鳞癌组)作为研究对象,两组均进行能谱CT定量扫描,比较两组有效原子序数(Eff-Z)、标准化碘浓度(NIC)、能谱曲线斜率水平,并分析三者对肺腺癌与鳞癌的诊断价值。结果肺腺癌组Eff-Z、NIC、能谱曲线斜率水平高于肺鳞癌组(t=4.882;t=3.185;t=4.658,P<0.05);ROC曲线显示,Eff-Z、NIC、能谱曲线斜率联合诊断的AUC为0.863高于Eff-Z的0.763、NIC的0.703、能谱曲线斜率的0.743(Z=2.600;Z=3.277;Z=2.756,P<0.05);肺腺癌组周围型分布、磨玻璃结节、胸膜凹陷征占比高于肺鳞癌组,血管集束征、侵犯纵膈占比低于肺鳞癌组(P<0.05)。结论能谱CT定量对肺腺癌与鳞癌具有较高的鉴别诊断价值。

Objective To explore the value of spectral computed tomography(CT)quantification in the differential diagnosis of lung adenocarcinoma and squamous cell carcinoma.Methods A total of 58 patients with lung adenocarcinoma(adenocarcinoma group)and 42 patients with lung squamous cell carcinoma(squamous cell carcinoma group)were retrospectively enrolled as the research objects between March 2018 and May 2021.Both groups underwent spectral CT quantitative scans.The effective atomic number(Eff-Z),normalized iodine concentration(NIC)and spectral curve slope between the two groups were compared,and their diagnostic value for lung adenocarcinoma and squamous cell carcinoma was analyzed.Results Eff-Z,NIC and spectral curve slope in adenocarcinoma group were higher than those in squamous cell carcinoma group(t=4.882;t=3.185;t=4.658,P<0.05).ROC curves analysis showed that AUC of Eff-Z combined with NIC and spectral curve slope was 0.863,greater than that of single index(0.763,0.703,0.743)(Z=2.600;Z=3.277;Z=2.756,P<0.05).The proportions of peripheral distribution,ground-glass nodules and pleural indentation in adenocarcinoma group were higher than those in squamous cell carcinoma group,while proportions of vessel convergence sign and mediastinal invasion were lower than those in squamous cell carcinoma group(P<0.05).Conclusion Value of spectral CT quantification is high in the differential diagnosis of lung adenocarcinoma and squamous cell carcinoma.