能谱成像技术诊断颈部甲癌转移淋巴结、鳞癌转移淋巴结及淋巴瘤  

Spectral imaging technique diagnosis the metastatic lymph nodes in thyroid carcinoma, squamous cell carcinoma metastatic lymph nodes and lymphoma

作　　者：李青青[1] 杨斌[2] 柯腾飞 李德艳[1] 赵卫[1] 熊倩[1] 杨亚英[1] 

机构地区：[1]昆明医科大学第一附属医院医学影像科,云南昆明650032 [2]大理学院附属医院放射科

出　　处：《实用放射学杂志》2015年第5期740-743,758,共5页Journal of Practical Radiology

摘　　要：目的：探讨双能量 CT 能谱成像技术在颈部甲癌转移淋巴结、鳞癌转移淋巴结与淋巴瘤诊断中的价值。方法经病理证实的30例患者共79枚颈部肿大淋巴结,均行双能量双期增强扫描后在 MMWP 后处理工作站上通过双能自配后处理软件（Mono Energetic）,观察能谱曲线变化趋势并比较3种不同病理性质淋巴结能谱曲线斜率。结果79枚淋巴结中甲癌转移性淋巴结23枚,鳞癌转移性淋巴结24枚,淋巴瘤32枚。在60~180 keV 范围内,随着单能 keV 值的升高,3种恶性淋巴结动脉期及实质期的 CT 值逐渐递减,且 keV 值越高,CT 值降低的幅度越小,其能谱曲线在60~180 keV 下均呈“下降型”。3种恶性淋巴结曲线斜率不同,甲癌转移淋巴结动脉期及实质期斜率最大,分别为1.23±0.41及0.85±0.33,淋巴瘤的动脉期及实质期斜率最小,分别为0.40±0.16及0.47±0.09；鳞癌转移淋巴结的动脉期及实质期斜率分别为0.88±0.10及0.62±0.28,3种恶性淋巴结动脉期、实质期斜率差异均有统计学意义。结论动脉期及实质期能谱曲线斜率对颈部甲癌转移淋巴结、鳞癌转移淋巴结与淋巴瘤的影像鉴别诊断均有一定的意义。Objective To explore the value of spectral imaging technique in dual-energy CT in differential diagnosis of the metastatic lymph nodes in thyroid carcinoma,squamous cell carcinoma metastatic lymph nodes and lymphoma in the neck.Methods In 30 patients with pathologically confirmed with a total of 79 cervical lymph nodes enlargement which were using dual energy scan .Then observed the change trend of the spectrum curve and comparison the three kinds of lymph node energy spectrum curve’s slope.Results In the 79 lymph nodes,the metastatic lymph nodes in thyroid carcinoma were twenty-three,squamous cell carcinoma metastatic lymph nodes were twenty-four and lymphoma were thirty-two.From 60 to 180 keV,with the increase of keV values,the three kinds of malignant lymph nodes of the corresponding CT value decreasing and the higher the keV value,the CT value decrease magnitude was small,and the spectrum curve was〞drop type〞.The slope spectrum curve of the metastatic lymph nodes of thyroid carcinoma in arterial phase and parenchymal phase were maximum,which were 1.23±0.41 and 0.85±0.33,respectively.The slope spectrum curve of lymphoma in arterial phase and parenchymal phase were least,whcih were 0.40±0.16 and 0.47 ±0.09.The slope spectrum curve of the squamous cell carcinoma metastatic lymph nodes in arterial phase and parenchymal phase were 0.88±0.10 and 0.62±0.28.The energy spectrum curve slope of the three kinds of malignant lymph nodes have statistical significance.Conclusion The energy spectrum curve slope of arterial phase and parenchymal phase has some significance lymph node metastasis of in thyroid carcinoma,the metastatic lymph nodes and lymphoma in the neck.

关 键 词：甲癌转移淋巴结 鳞癌转移淋巴结 淋巴瘤 能谱成像技术 能谱曲线 计算机体层成像 

分 类 号：R739.91[医药卫生—肿瘤] R445.2[医药卫生—临床医学]