低剂量能谱CT结合多平面重建技术对肺癌和肺炎性结节鉴别诊断意义  

Value of low-dose energy spectrum CT combined with multiplanar reconstruction in the differential diagnosis of lung cancer and pneumonia nodules

作　　者：贾乃龙 李传资 王绥煌[1] 张余鹏 林志华 林昌昆 黄垂志 Jia Nailong;Li Chuanzi;Wang Suihuang;Zhang Yupeng;Lin Zhihua;Lin Changkun;Huang Chuizhi(Department of Radiology,the Second Affiliated Hospital of Hainan Medical College,Haikou 570311)

机构地区：[1]海南医学院第二附属医院放射科,海口570311

出　　处：《中华肺部疾病杂志（电子版）》2024年第2期247-251,共5页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：海南省卫生健康行业科研项目(22A200268)。

摘　　要：目的分析低剂量能谱CT结合多平面重建技术(multiplanar reformation,MPR)对肺癌及肺炎性结节的鉴别诊断意义。方法选取2021年2月至2023年2月我院收治的经病理确诊并行能谱CT结合MPR检测患者115例,根据病理结果分为肺炎性结节组49例、肺鳞癌组31例和肺腺癌组35例,分析每组动、静脉期碘含量、水含量及标准能谱衰减曲线斜率K值,比较肺影像学表现。结果肺炎性结节组、肺鳞癌组和肺腺癌组动脉期碘含量[(4.51±0.43)vs.(5.74±0.38)vs.(7.09±0.31)]mg/ml、水含量[(958.47±130.25)vs.(1089.36±132.78)vs.(1102.25±127.28)]mg/ml、标准化能谱衰减曲线斜率[(0.61±0.05)vs.(0.82±0.04)vs.(0.97±0.07)]Kev和静脉期的碘含量[(7.36±0.18)vs.(7.80±0.17)vs.(8.59±0.28)]mg/ml逐渐升高(P<0.05);肺炎性结节组、肺鳞癌组和肺腺癌组静脉期的水含量[(1017.46±98.36)vs.(1045.67±101.28)vs.(1038.19±97.28)]mg/ml和标准能谱衰减曲线斜率[(0.59±0.05)vs.(0.60±0.03)vs.(0.61±0.06)]Kev比较(P>0.05);肺炎性结节与肺鳞癌、肺腺癌影像学表现比较,差异有统计学意义(P<0.05),肺鳞癌和肺腺癌影像学表现,胸膜凹陷征差异有统计学意义(P<0.05)。结论低剂量能谱CT结合MPR的定量分析对肺炎性结节、肺鳞癌与肺腺癌的诊断与鉴别诊断有临床意义。Objective To analyze the significance of low-dose energy spectrum CT combined with multiplanar reformation(MPR)in the differential diagnosis of lung cancer and pneumonia nodules.Methods A total of 115 patients admitted to our hospital from February 2021 to February 2023 who were pathologically confirmed and underwent energy spectrum CT and MPR examination were divided into 49 patients with pneumonia nodule group,31 patients with lung squamous cell carcinoma group and 35 patients with lung adenocarcinoma group according to pathological results.Iodine content,water content and slope K value of standard energy spectrum decay curve of each group were analyzed,and the imaging findings were compared.Results Arterial iodine content[(4.51±0.43)vs.(5.74±0.38)vs.(7.09±0.31)]mg/ml and water content[(958.47±130.25)vs.(1089.36±132.78)vs.(1102.25±127.28)]mg/ml in pulmonary nodules,squamous cell carcinoma and adenocarcinoma groups,slope of standardized energy spectrum decay curve[(0.61±0.05)vs.(0.82±0.04)vs.(0.97±0.07)]Iodine content in Kev andⅣstage[(7.36±0.18)vs.(7.80±0.17)vs.(8.59±0.28)]mg/ml gradually increased(P<0.05);Water content in venous stage of pulmonary nodules,squamous cell carcinoma and adenocarcinoma groups[(1017.46±98.36)vs.(1045.67±101.28)vs.(1038.19±97.28)]mg/ml and slope of standard energy spectrum decay curve[(0.59±0.05)vs.(0.60±0.03)vs.(0.61±0.06)]Kev comparison(P>0.05);There were statistically significant differences in the imaging findings of pulmonary nodules and lung squamous carcinoma and lung adenocarcinoma(P<0.05),while there were statistically significant differences in the imaging findings of lung squamous carcinoma and lung adenocarcinoma and pleural depression sign(P<0.05).Conclusion The quantitative analysis of low-dose energy spectrum CT combined with MPR is of clinical significance in the differential diagnosis of pulmonary nodules,lung squamous cell carcinoma and lung adenocarcinoma.

关 键 词：肺炎性结节 肺腺癌 肺鳞癌 低剂量能谱CT 多平面重建 

分 类 号：R563[医药卫生—呼吸系统] R734.2[医药卫生—内科学]