能谱CT成像技术在肺部良恶性肿瘤中的诊断价值

Diagnostic value of spectral CT in benign and malignant lung tumors

目的探讨能谱CT成像技术在肺部良恶性肿瘤中的诊断价值。方法收集能谱CT双期扫描且经病理证实的肺部占位患者40例,其中恶性20例(鳞癌10例,腺癌7例,其他3例),良性20例,通过能谱分析软件,获取动脉期、静脉期占位灶感兴趣区的碘浓度、水浓度及40~140 keV(以10 keV为间隔)各能量水平CT值(HU),并计算动脉期、静脉期其不同能量水平下的能谱曲线斜率。结果动脉期及静脉期良恶性肿瘤之间在不同keV(40、60、80、100、120、140 keV)对应的CT值及碘浓度能谱曲线斜率差异均具有统计学意义(P<0.01),而动脉期及静脉期良恶性肿瘤之间的水浓度差异无统计学意义(t=1.679、1.808,P>0.05)。动脉期鳞癌与腺癌在不同keV下对应的CT值差异及碘值差异均具有统计学意义(P<0.05),静脉期肺鳞癌与腺癌不同keV下对应的CT值差异及碘浓度差异无统计学意义(P>0.05),动脉期及静脉期鳞癌与腺癌的水浓度及能谱曲线斜率差异亦无统计学意义(P>0.05)。结论 CT能谱成像联合多参数定量分析,在肺部良恶性肿瘤的诊断及鉴别诊断中具有一定的临床价值。

Objective To investigate the diagnostic value of the energy spectrum of CT imaging in benign and malignant lung tumor.Methods Collected 40 patients with pulmonary occupied lesions who underwent the energy spectrum CT dual phase scanning,including 20 cases of malignant(10 cases of squamous cell carcinoma,7 cases of adenocarcinoma and 3 cases of others),and 20 cases of benign lesions,through the spectrum analysis software,acquired the iodine concentration of the focal region of interest at arterial phase,venous phase,water concentration and 40- 140 keV(at 10 keV intervals) energy levels of the CT value(HU),and calculated the spectrum curve slope in arterial phase,venous phase under the different energy levels.Results There were statistically significant difference of CT value and the concentration of iodine spectrum curve slope at different keV(40,60,80,100,120,140 keV) between the arterial phase and portal venous phase of benign and malignant tumors(P <0.01),but no significant differences of water concentration at the arterial phase and venous phase between benign and malignant tumors(t =1.679,t =1.808,P >0.05).There were statistically significant differences of CT value under different keV and iodine value at arterial phase between squamous cell carcinoma and adenocarcinoma(P <0.05),and there were no statistical significance differences of CT value under different keV and iodine concentration at the venous phase between pulmonary squamous carcinoma and adenocarcinoma(P > 0.05),there were no statistically significant differences of water concentration and energy spectrum curve slope at arterial and intravenous pulse between squamous cell carcinoma and adenocarcinoma(P >0.05).Conclusion It showed that the CT spectral imaging combined with multi parameter quantitative analysis has some clinical value in diagnosis and differential diagnosis of benign and malignant lung tumor.