能谱CT成像定量分析在评估肺癌病理类型和分化程度中的应用价值  

Application value of spectral CT imaging quantitative analysis in evaluating pathological types and differentiation degree of lung cancer

作　　者：朱永寅 姚晶晶 雨托成 周凡[1] 阳明[1] ZHU Yong-yin;YAO Jing-jing;YU Tuo-cheng;ZHOU Fan;YANG Ming(Department of Medical Imaging,Luzhou People′s Hospital,Luzhou,Sichuan 646000,China;Department of Radiology,Affiliated Hospital of Traditional Chinese Medicine,Southwest Medical University,Luzhou,Sichuan 646000,China)

机构地区：[1]泸州市人民医院医学影像科,四川泸州646000 [2]西南医科大学附属中医医院放射科,四川泸州646000

出　　处：《临床肺科杂志》2022年第7期1092-1096,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨能谱CT成像定量分析在评估肺癌病理类型和分化程度中的应用价值。方法选取2019年1月至2020年10月106例肺癌患者。根据病理类型分为非小细胞癌86例(鳞癌39例、腺癌47例)、小细胞癌20例。根据肿瘤分化程度分为低分化40例、中高分化66例。所有患者进行能谱CT成像,比较定量参数,采用ROC曲线分析诊断价值。结果腺癌组的平扫能谱曲线斜率、动脉期能谱曲线斜率、碘浓度,均大于鳞癌组(P<0.05),且鳞癌组大于小细胞癌组(P<0.05)。低分化肺癌组的平扫能谱曲线斜率、动脉期能谱曲线斜率、碘浓度均小于中高分化肺癌组(P<0.05)。平扫能谱曲线斜率、动脉期能谱曲线斜率、碘浓度鉴别诊断小细胞癌与非小细胞癌的灵敏度,分别为76.74%、86.05%、67.44%,特异度分别为90.00%、75.00%、95.00%;鉴别诊断低分化与中高分化肺癌的灵敏度分别为63.64%、84.85%、75.76%,特异度分别为65.00%、42.50%、72.50%。结论能谱CT成像定量参数对鉴别诊断肺癌病理类型和分化程度具有一定指导意义。Objective To explore the application value of spectral CT imaging quantitative analysis in evaluating pathological types and differentiation degree of lung cancer.Methods A total of 106 lung cancer patients from January 2019 to October 2020 were selected.According to the pathological type,they were divided into 86 cases of non-small cell carcinoma(39 cases of squamous cell carcinoma,47 cases of adenocarcinoma)and 20 cases of small cell carcinoma.According to the degree of tumor differentiation,the tumors were divided into 40 cases with low differentiation and 66 cases with medium and high differentiation.Spectral CT imaging was performed in all patients,quantitative parameters were compared,and a ROC curve was used to analyze the diagnostic value.Results The slope of the plain and arterial phase energy spectrum curve,and the iodine concentration in the adenocarcinoma group were higher than those in the squamous cell carcinoma group(P<0.05).The slope of plain and arterial phase spectral curve and iodine concentration in the low differentiation group were lower than those in the moderate-high differentiation group(P<0.05).The sensitivity of plain scan spectral curve slope,arterial phase spectral curve slope,and iodine concentration in the differential diagnosis of small cell carcinoma and non-small cell carcinoma were 76.74%,86.05%,and 67.44%.respectively,and the specificities were 90.00%,75.00%,and 95.00%,respectively.The sensitivity of differential diagnosis of poorly differentiated and moderate-high differentiated lung cancer was 63.64%,84.85%,75.76%,and the specificity was 65.00%,42.50%,and 72.50%,respectively.Conclusion The quantitative parameters of spectral CT imaging have certain guiding significance for the differential diagnosis of the pathological type and differentiation degree of lung cancer.

关 键 词：肺癌 能谱CT 病理类型 分化程度 定量分析 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]