CT双能量成像参数对肺结节病变性质的鉴别价值研究  

The clinical value of dual-energy CT imaging parameters in differentiating the pathological properties of pulmonary nodules

作　　者：张东升[1] 盛茂[1] 何家伟[1] 陶磊[1] ZHANG Dong-sheng;SHENG Mao;HE Jia-wei;TAO Lei(Department of Imaging Center,the Second People's Hospital of Hefei,Hefei 230000,China)

机构地区：[1]合肥市第二人民医院影像中心,安徽合肥230000

出　　处：《中国临床医学影像杂志》2024年第6期406-410,共5页Journal of China Clinic Medical Imaging

基　　金：合肥市第二人民医院2022年度院级科研项目(2022yyb013)。

摘　　要：目的:研究CT双能量成像参数对肺结节病变性质的鉴别价值。方法:2021年12月一2023年1月合肥市第二人民医院收治的102例恶性肺结节患者作为恶性组,同期收治的106例良性肺结节患者作为良性组,所有患者均经病理学检查确诊,比较两组患者影像学特征及CT双能量成像参数,进行肺结节病变性质的CT双能量成像征象、参数多因素分析,采用受试者工作特征(ROC)曲线分析CT双能量成像参数对肺结节病变性质的鉴别价值。结果:恶性组强化不均匀、淋巴结增大、结节边缘毛刺/分叶、血管受累患者占比高于良性组(P<0.05)。恶性组动脉期、静脉期能谱曲线斜率及容积CT剂量指数均高于良性组(P<0.05)。多因素Logistic回归分析结果显示,动脉期、静脉期能谱曲线斜率及容积CT剂量指数较高是肺结节恶性病变的危险因素(OR=1.451、1.502、1.640,P<0.05)。动脉期、静脉期能谱曲线斜率及容积CT剂量指数联合鉴别肺结节病变性质的曲线下面积(AUC)值高于三者单独检测(P<0.05)。结论:肺结节良性病变和恶性病变患者之间影像学特征、动脉期及静脉期能谱曲线斜率、容积CT剂量指数存在明显差异,且动脉期、静脉期能谱曲线斜率及容积CT剂量指数是肺结节恶性病变的危险因素,三者联合对肺结节病变性质的鉴别具有较好价值。Objective:To investigate the clinical value of dual-energy CT imaging parameters in differentiating the pathological properties of pulmonary nodules.Methods:From December 2021 to January 2023,102 patients with malignant pulmonary nodules in the Second People's Hospital of Hefei were treated as malignant group,and 106 patients with benign pulmonary nodules in the same hospital were treated as benign group.All patients were diagnosed by pathological examination.The morphological characteristics of dual-energy CT imaging of the two groups were analyzed by both t-test and multivariate regression analysis.Receiver operating characteristic(ROC)curve was used to analyze the differential value of dual-energy CT imaging parameters for the properties of pulmonary nodules.Results:The proportion of patients with uneven enhancement,lymph node enlargement,burr/lobule and vascular involvement in the malignant group was higher than that in the benign group(P<0.05).The slope of energy spectrum curve and volume CT dose index of arterial and venous phases in the malignant group were higher than those in the benign group(P<0.05).Multivariate Logistic regression analysis showed that the higher slope of energy spectrum curve and volume CT dose index in arterial and venous phases were the risk factors for malignant lesions of pulmonary nodules(OR=1.451,1.502,1.640,P<0.05).The area under the curve(AUC)value of energy spectrum curve slope and volumetric CT dose index combined with the characteristics of pulmonary nodules in arterial and venous phases was higher than that of the three tests alone(P<0.05).Conclusion:There were obvious differences in imaging morphological characteristics,arterial phase and venous phase energy spectrum curve slope and volume CT dose index between patients with benign lung nodules and patients with malignant lung nodules,and the arterial phase and venous phase energy spectrum curve slope and volume CT dose index were risk factors for malignant lung nodules,and the combination of the three was of good value in

关 键 词：肺肿瘤 体层摄影术 螺旋计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]