摘要
目的探讨能谱CT平扫定量分析鉴别诊断周围型肺癌和结核球的价值。方法回顾性分析于我院接受能谱CT扫描并经病理证实为单发肺结节或肿块的51例患者的资料,其中结核球15例(结核组),周围型肺癌36例(肺癌组)。分析并比较2组能谱CT平扫定量参数,包括40~140 keV单能量CT值、能谱衰减曲线类型及斜率、基物质对浓度和有效原子序数(Eff-Z)。结果肺癌组40~70 keV单能量CT值均高于结核组(P均<0.05),而2组间80~140 keV单能量CT值差异均无统计学意义(P均>0.05)。肺癌组平扫能谱衰减曲线类型均呈快速下降型(36/36,100%),结核组能谱衰减曲线呈平直型(11/15,73.33%)和弓背上抬型(4/15,26.67%);肺癌组40~65 keV、65~90 keV、90~140 keV平扫能谱衰减曲线斜率(K_(40~65 keV)、K_(65~90 keV)、K_(90~140 keV))均高于结核组(P均<0.01)。肺癌组钙(水)浓度高于结核组(P<0.01),而脂(水)浓度低于结核组(P<0.01);2组水(钙)浓度差异无统计学意义(P=0.10)。肺癌组Eff-Z明显高于结核组(P<0.01)。结论周围型肺癌与结核球具有不同的能谱CT定量参数指标,能谱CT平扫即可为两者的鉴别诊断提供有价值的参考信息。
Objective To investigate the value of quantitative analysis of spectrum CT in the differential diagnosis of lung cancer and tuberculosis in unenhanced phase.Methods Data of 51 patients with solitary pulmonary nodules or masses confirmed by pathology who underwent chest unenhanced spectrum CT were retrospectively analyzed.There were 36 cases of peripheral lung cancer（lung cancer group）and 15 cases of tuberculosis（tuberculosis group）.The differences of 40~140 keV single energy CT value,shape and slope of energy spectrum attenuation curve,different base material of concentration values and effective atomic number（Eff-Z）between the two groups were compared.Results The single energy CT values of 40~70 keV in lung cancer group were higher than those in tuberculosis group（all P〈0.05）,while no significant difference of the single energy CT values of 80~140 keV were found in both two groups（all P〈0.05）.The shape of energy spectrum attenuation curve of lung cancer group was fast express reduction（36/36,100%）.The energy spectrum attenuation curve of tuberculosis group showed walked straightly（11/15,73.33%）and back-up type（4/15,26.67%）.The slope of the energy spectrum attenuation curve in lung cancer group（K（40~65 keV）、K（65~90 keV）、K（90~140 keV））were higher than those in tuberculosis group（all P〈0.01）.The calcium（water）concentration of lung cancer group was higher than that of tuberculosis group（P〈0.01）,while the lipid（water）concentration of lung cancer group was lower than that of tuberculosis group（P〈0.01）.The water（calcium）concentration in both groups was not statistically different（P=0.10）.The Eff-Z of lung cancer group was higher than that of the tuberculosis group（P〈0.01）.Conclusion The peripheral lung cancer and the tuberculosis have different energy spectrum CT quantitative parameters in unenhanced phase,which can provide valuable informations for diagnosis.
出处
《中国医学影像技术》
CSCD
北大核心
2017年第8期1206-1210,共5页
Chinese Journal of Medical Imaging Technology
基金
国家临床重点专科建设项目(国卫办医涵[2013]544号)
关键词
肺肿瘤
结核
宝石能谱成像
体层摄影术
X线计算机
Lung neoplasms
Tuberculosis
Gemstone spectral imaging
Tomography
X-ray computed
