能谱CT扫描技术在肺良恶性病变鉴别诊断中的初步研究  

Value of spectral CT in differential diagnosis of benign and malignant lesions in the lung

作　　者：夏平[1] 陈刚[1] 郝敬明[1] 曹伟[1] 师毅冰[1] 

机构地区：[1]徐州市中心医院CT室,江苏徐州221009

出　　处：《实用放射学杂志》2015年第3期473-476,共4页Journal of Practical Radiology

摘　　要：目的：探讨能谱成像在肺良恶性肿块中影像诊断的价值。方法采用 GE能谱CT对64例 CT平扫首次发现的肺内肿块进行能谱增强扫描，其中肺癌42例，炎性病变22例。通过能谱分析软件，获取肿块内感兴趣区的能谱曲线、碘基图、水基图及101组单能图像，分别测量各项能谱参数，比较良恶性病变间的差异。结果肺癌组与炎性病变组50 keV、70 keV下对应的 CT值分别为（97.82±29.74）HU、（61.18±15.75）HU及（144.34±47.14）HU、（82.52±25.10）HU（P＜0.01）；能谱曲线斜率分别为1.83±0.84、3.10±1.23（P＜0.01）；碘浓度分别为（13.31±6.44）mg/mL、（21.72±9.16）mg/mL（P＜0.01）；有效原子序数（Eff-Z）分别为8.36±0.33、8.95±0.91（P＜0.01）。肿瘤各项参数均低于炎性病变组。单能图像能够较好地显示肿块内的血管情况，并且有助于肿块与肺不张边界的划分。结论宝石能谱成像多参数定量分析在肺良恶性疾病的诊断中具有价值。Objective To investigate the value of spectral CT in differential diagnosis of benign and malignant lesions in the lung. Methods Sixty-four patients who had lung nodule or mass on plain CT underwent spectral CT enhancement scan.The spectrum energy curve, iodine concentration,water concentration and 101 sets of monochromatic images were analyzed by the software on a gemstone spectral imaging （GSI）viewer.The patients were divided into two groups including tumor group in 42 patients and pneumonia one in 22.The differences in the analyzed parameters between two groups were compared.Results In tumor and pneumonia groups,the differences were found in corresponding CT values （97.82±29.74）HU and （144.34±47.14）HU at 50 keV and （61.18±15.75）HU and （82.52±25.10）HU at 70 keV,the slope rates of spectrum energy curves 1.83±0.84 and 3.10±1.23,the iodine concentration （13.31±6.44）mg/mL and （21.72±9.16）mg/mL,and the effective-Z 8.36±0.33 and 8.95±0.91 respectively （P〈0.01）.Monochromatic images can show well the blood vessel in the tumor and help to discriminate the border between tumor and atelectasis.Conclusion Spectral CT plays an important role in the differential diagnosis of benign and malignant lesions in the lung.

关 键 词：肺肿瘤 肺炎 计算机体层成像 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]