CT能谱成像参数联合血清细胞角蛋白19片段抗原21-1水平对孤立性肺结节性质的鉴别诊断价值  

Value of CT Spectral Imaging Parameters Combined with Serum Cyto-Keratin 19 Fragment Antigen 21-1 Level in the Differential Diagnosis of the Nature of Solitary Pulmonary Nodules

作　　者：陈晓雪 李可峰 韩海森 李依明[2] CHEN Xiaoxue;LI Kefeng;HAN Haisen;LI Yiming(Imaging Department,Shangqiu Hospital of Traditional Chinese Medicine,Shangqiu 476000,China;Imaging Department,the First People's Hospital of Shangqiu City,Shangqiu 476000,China)

机构地区：[1]河南省商丘市中医院影像科,476000 [2]河南省商丘市第一人民医院影像科,476000

出　　处：《实用心脑肺血管病杂志》2024年第9期95-98,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：2019年度河南省医学科技攻关计划联合共建项目(LHGJ20191496)。

摘　　要：目的分析CT能谱成像参数联合血清细胞角蛋白19片段抗原21-1(CYFRA21-1)水平对孤立性肺结节性质的鉴别诊断价值。方法回顾性选取2023年1月—2024年1月于商丘市中医院就诊的孤立性肺结节患者93例为研究对象。根据结节性质将患者分为良性组(60例)和恶性组(33例)。收集患者一般资料及临床资料,采用ROC曲线分析CT能谱成像参数、血清CYFRA21-1水平及其联合对孤立性肺结节性质的鉴别诊断价值。结果恶性组动脉期、静脉期标准化碘浓度、碘含量、40 keV水平下CT值、70 keV水平下CT值、100 keV水平下CT值、140 keV水平下CT值及血清CYFRA21-1水平高于良性组(P<0.05)。ROC曲线分析结果显示,动脉期、静脉期标准化碘浓度、碘含量、40 keV水平下CT值、70 keV水平下CT值、100 keV水平下CT值、140 keV水平下CT值及血清CYFRA21-1水平鉴别诊断良、恶性孤立性肺结节的AUC均<0.800,而其联合鉴别诊断良、恶性孤立性肺结节的AUC为0.861[95%CI(0.849~0.874)]。结论CT能谱成像参数[静脉期、动脉期标准化碘浓度、碘含量及不同CT能量水平(40、70、100、140keV)下的CT值]联合血清CYFRA21-1水平对良、恶性孤立性肺结节具有一定鉴别诊断价值。Objective To analyze the value of CT spectral imaging parameters combined with serum cyto-keratin 19 fragment antigen 21-1(CYFRA21-1)level in the differential diagnosis of the nature of solitary pulmonary nodules.Methods Ninety-three patients with solitary pulmonary nodules who were treated in Shangqiu Hospital of Traditional Chinese Medicine from January 2023 to January 2024 were retrospectively selected as the study objects.The patients were divided into benign group(60 cases)and malignant group(33 cases)according to the nodule nature.General data and clinical data of patients were collected,and ROC curve was used to analyze the value of CT spectral imaging parameters,serum CYFRA21-1 level and their combination in the differential diagnosis of the nature of solitary pulmonary nodules.Results The standardized iodine concentration,iodine content,CT values at 40 keV level,CT values at 70 keV level,CT values at 100 keV level,CT values at 140 keV level and serum CYFRA21-1 level in arterial and venous phases in malignant group were higher than those in benign group(P<0.05).ROC curve analysis results showed that,the standardized iodine concentration,iodine content,CT values at 40 keV level,CT values at 70 keV level,CT values at 100 keV level,CT values at 140 keV level and serum CYFRA21-1 level in arterial and venous phases in distinguishing benign and malignant solitary pulmonary nodules was less than 0.800,while the AUC of their combination in distinguishing benign and malignant solitary pulmonary nodules was 0.861[95%CI(0.849-0.874)].Conclusion CT spectral imaging parameters[standardized iodine concentration,iodine content,CT values at different CT energy levels(40,70,100,140 keV)in venous and arterial phases]combined with serum CYFRA21-1 levels have a certain value in the differential diagnosis of benign and malignant solitary pulmonary nodules.

关 键 词：孤立性肺结节 CT能谱成像 细胞角蛋白19片段抗原21-1 诊断 鉴别 

分 类 号：R521.6[医药卫生—内科学]