双层探测器光谱CT多参数成像在不同病理类型肺癌中的应用  

Application of Dual-layer Detector Spectral CT Multi-parameter Imaging in Different Pathological Types of Lung Cancer

作　　者：薛莉雅 赵卫东[2] 苏琳[1] 董卓瑞 XUE Li-ya;ZHAO Wei-dong;SU Lin;DONG Zhuo-rui(Department of Medical Imaging,Shanxi Medical University,Taiyuan 030000,Shanxi Province,China;Department of Medical Imaging,the Second Hospital of Shanxi Medical University,Taiyuan 030000,Shanxi Province,China)

机构地区：[1]山西医科大学医学影像学院,山西太原030000 [2]山西医科大学第二医院影像科,山西太原030000

出　　处：《中国CT和MRI杂志》2023年第12期52-55,共4页Chinese Journal of CT and MRI

摘　　要：目的探究双层探测器光谱CT(dual-layer spectral detector CT,DSCT)定量参数对肺癌不同病理类型的诊断评估。方法回顾性分析2021年8月至2022年11月总计88例肺癌患者在我院DSCT进行胸部双期增强扫描的病例,根据病理结果分为肺腺癌组(n=42)、鳞癌组(n=30)及小细胞肺癌组(n=16)。对三组动脉期和静脉期碘浓度(iodine concentration,IC)、标准化碘浓度(normalized iodine concentration,NIC)、有效原子序数(Z-effective,Zeff)、能谱曲线斜率(K40~100keV)及40~100keV(间隔10keV)的单能量CT值进行测量、计算和分析。运用统计学方法:单因素方差分析对数据进行分析。绘制受试者工作特征曲线(receiver operator characteristic curve,ROC),计算曲线下面积(area under the cure,AUC)分析光谱CT各参数鉴别诊断肺腺癌与非肺腺癌、非小细胞肺癌与小细胞肺癌的效能并计算灵敏度、特异度、约登指数。结果静脉期肺腺癌IC、NIC、Zeff、K40~100keV及CT40keV高于鳞癌和小细胞肺癌;静脉期肺腺癌CT50keV、CT60keV高于小细胞肺癌;动脉期肺腺癌NIC高于小细胞肺癌,差异均具有统计学意义(P<0.05)。绘制ROC,静脉期K40~100keV诊断肺腺癌与非肺腺癌的AUC最大值为0.815,诊断阈值、灵敏度和特异度分别为1.505、92.9%和65.2%。静脉期K40~100keV诊断非小细胞肺癌与小细胞肺癌的AUC最大值为0.768,诊断阈值、灵敏度和特异度分别为1.418、76.4%和75.0%。结论双层探测器光谱CT定量参数在评估肺癌病理类型中具有一定参考价值。Objective To explore the diagnostic evaluation of quantitative parameters of dual-layer spectral detector CT(DSCT)for different pathological types of lung cancer.Methods From August 2021 to November 2022,a total of 88 patients with lung cancer underwent chest dual-phase enhanced scanning with DSCT in our hospital were retrospectively analyzed.According to the pathological results,they were divided into lung adenocarcinoma group(n=42),squamous cell carcinoma group(n=30)and small cell lung cancer group(n=16).The iodine concentration(IC),normalized iodine concentration(NIC),effective atomic number(Zeff),slope of energy spectrum curve(K40~100keV)and single energy CT values of 40~100keV(interval 10keV)were measured,calculated and analyzed in the three groups.The data were analyzed using statistical methods:one-way analysis of variance.Draw the receiver operator characteristic curve(ROC)of the subject,calculate the area under the curve(AUC)and analyze the efficiency of spectral CT parameters in differentiating lung adenocarcinoma and non-lung adenocarcinoma,non-small cell lung cancer and small cell lung cancer,and calculate the sensitivity,specificity,Youden index.Results IC,NIC,Zeff,K40~100keV and CT40keV in venous phase of lung adenocarcinoma were higher than those in the squamous cell carcinoma and small cell lung cancer;CT50keV and CT60keV in venous phase of lung adenocarcinoma were higher than those in the small cell lung cancer.The NIC in arterial phase of lung adenocarcinoma was higher than that in the small cell lung cancer,and the differences were statistically significant(P<0.05).When ROC was plotted,the maximum AUC of K40~100keV in venous phase for diagnosis of lung adenocarcinoma and non-lung adenocarcinoma was 0.815,and the diagnostic threshold,sensitivity and specificity were 1.505,92.9%and 65.2%,respectively.The maximum AUC of K40~100keV in venous phase for diagnosis of non-small cell lung cancer and small cell lung cancer was 0.768,and the diagnostic threshold,sensitivity and specificity were 1.418,76.4

关 键 词：光谱CT 肺癌 病理类型 

分 类 号：R734.2[医药卫生—肿瘤]