能谱CT定性诊断胸腔积液性质研究  

Value of spectral CT to the qualitative diagnosis of pleural effusion

作　　者：骆佳[1] 钟桥维 张秀红[1] 李德永[1] 张红[2] 

机构地区：[1]惠州市第三人民医院影像科,广东惠州516001 [2]惠州市第三人民医院肿瘤科,广东惠州516001

出　　处：《中华实用诊断与治疗杂志》2015年第5期496-498,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：惠州市科技局课题(2012226)

摘　　要：目的应用能谱CT对胸腔积液进行定性分析,为临床制定治疗方案提供参考。方法 50例胸腔积液患者经胸腔穿刺术抽出胸腔积液后,分别行常规生化检查和能谱CT扫描。根据常规生化检查结果,将50例患者分为渗出液组和漏出液组,应用能谱分析软件分析2组常规混合能量CT值、40~140keV单能量CT值、能谱曲线斜率以及漏出液或渗出液中配对基物质浓度值。结果常规生化检查结果确定漏出液22例（漏出液组）和渗出液28例（渗出液组）;渗出液组常规混合能量CT值[（19.42±3.97）Hu]高于漏出液组[（13.35±3.26）Hu]（P〈0.05）,能谱曲线斜率（0.498）高于漏出液组（0.176）（P〈0.05）;40、50、60、70、80、90、100、110、120、130keV单能量下,渗出液组CT值明显高于漏出液组（P〈0.05）;渗出液组140keV单能量下CT值[（9.82±2.59）Hu]与漏出液组[（6.14±2.51）Hu]组比较差异无统计学意义（P〉0.05）;渗出液组碘（水）[（5.86±1.21）g/L]、钙（水）[（7.93±1.74）g/L]、钙（脂肪）[（26.03±1.54）g/L]浓度值均高于漏出液组[碘（水）（1.81±0.67）g/L、钙（水）（2.62±1.32）g/L、钙（脂肪）（20.23±1.39）g/L]（P〈0.05）,水（钙）[（1 000.12±231.5）g/L]和脂肪（钙）[（979.94±1.42）g/L]浓度均低于漏出液组[水（钙）（1 203.52±208.31）g/L、脂肪（钙）（1 182.74±2.17）g/L]（P〈0.05）。结论渗出液与漏出液的能谱CT特征参数有明显差异,能谱CT可在短时间内快速、有效的对胸腔积液进行定性诊断。Objective To apply spectral CT in the qualitative analysis of pleural effusion to provide referent guidance for treatment program.Methods Fifty patients with pleural effusion received routine biochemical test and spectral CT scan after thoracentesis and were divided into exudate group and transudate group according to the biochemical test results.Spectrum analysis software was adopted to analyze the conventional mixed energy CT value,40 to 140keV single energy CT value,slope of spectral curve,and transudate and pairing group concentration value.Results Routine biochemical examination showed exudate in 22cases（exudates group）and transudate in 28cases（transudate group）.Conventional mixed energy value of CT was higher in exudate group（（19.42±3.97）Hu）than that in transudate group（（13.35±3.26）Hu）（P0.05）.The rate of spectral curve slope was higher in exudate group（0.498）than that in transudate group（0.176）（P0.05）.CT values of in exudate group on 40,50,60,70,80,90,100,110,120 and 130keV single energy were significantly higher than those in transudate group（P0.05）.There was no significant difference in the CT value on 140 keV single energy between exudate group（（9.82±2.59）Hu）and transudate group（（6.14±2.51）Hu）（P0.05）.Iodine-water concentration（（5.86±1.21）g/L）,calcium-water concentration（（7.93±1.74）g/L）and calcium-fat concentration（（26.03±1.54）g/L）were higher in exudate group than those in transudate group（（1.81±0.67）g/L,（2.62±1.32）g/L,（20.23±1.39）g/L）（P0.05）,water-calcium concentration（1 000.12±231.5）g/L）and fat-calcium concentration（（979.94±1.42）g/L）were lower in exudate group than those in transudate group（（1 203.52±208.31）g/L,（1 182.74±2.17）g/L）（P0.05）.Conclusion Exudate and transudate have different spectral CT parameters.Spectral CT can quickly and effectively make qualitative diagnosis of pleural effusion in a short time.

关 键 词：胸腔积液 能谱CT 渗出液和漏出液 定性 

分 类 号：R561.3[医药卫生—呼吸系统] R816.4[医药卫生—内科学]