能谱CT定量参数对脊柱转移瘤与多发性骨髓瘤的鉴别诊断价值

Value of Spectral CT Quantitative Parameters in the Differential Diagnosis of Metastatic Spine Tumors and Multiple Myeloma

目的探究能谱CT定量参数在脊柱转移瘤(MST)与多发性骨髓瘤(MM)鉴别诊断中的应用价值。方法回顾性选取60例脊柱恶性肿瘤患者为研究对象,并根据手术或穿刺活检结果将其分为MST组(39例)和MM组(21例),均行脊柱能谱CT扫描。比较2组能谱CT定量参数,并分析其对二者鉴别诊断的价值。结果MST组患者的临床表现和病变部位与MM组相比无明显差异(P>0.05);MST组在40~90 keV能量水平对应的CT值和曲线斜率K高于MM组(P>0.05);2组在100~140 keV能量水平对应的CT值比较无明显差异(P>0.05),且2组的CT值均随keV能量水平的增加而降低。结论能谱CT定量参数40~90 keV能量水平对应的CT值和曲线斜率K在MST和MM的鉴别诊断中具有一定的应用价值。

Objective To explore the value of spectral CT quantitative parameters in the differential diagnosis of metastatic spine tumors(MST)and multiple myeloma(MM).Methods A total of 60 patients with spinal malignancies pathologically confirmed were retrospectively enrolled as the research objects.According to the results of surgery or puncture biopsy,they were divided into MST group(39 cases)and MM group(21 cases).All patients underwent spectral CT scans.The spectral CT quantitative parameters were compared between the 2 groups and value of the parameters in the differential diagnosis of MST and MST was analyzed.Results There was no significant difference in clinical manifestations or lesion sites between the 2 groups(P>0.05).CT values under 40~90 keV and K in MST group were higher than those in MM group(P>0.05).There was no significant difference in CT values under 100~140 keV between the 2 groups(P>0.05).With the increase of energy level,CT values was decreased in both groups.Conclusion CT values under 40~90 keV and and slope K are valuable in the differential diagnosis of MST and MM.