能谱CT检查对肺部肿瘤良恶性的鉴别诊断价值  

Differential diagnostic value of energy spectral CT examination in benign and malignant lung tumors

作　　者：王培珍 丁孟丽 田成斌 WANG Peizhen;DING Mengli;TIAN Chengbin(Department of Radiology,General Hospital of Pingmei Shenma Medical Group,Pingdingshan 467000,He’nan,China)

机构地区：[1]平煤神马医疗集团总医院放射科,河南平顶山467000

出　　处：《癌症进展》2024年第16期1822-1824,1832,共4页Oncology Progress

摘　　要：目的探讨能谱CT检查对肺部肿瘤良恶性的鉴别诊断价值。方法选取156例肺部肿瘤患者,均接受常规多层螺旋CT和能谱CT检查。依据病理检查结果分为良性组(n=53)和恶性组(n=103),比较两组患者的常规CT值与能谱CT定量参数[斜率K、动静脉期标准化碘浓度(NIC)]。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估常规CT与能谱CT检查对肺部肿瘤良恶性的鉴别诊断价值。结果恶性组患者常规CT值以及能谱CT动脉期NIC、静脉期NIC、斜率K均明显高于良性组,差异均有统计学意义(P﹤0.01)。能谱CT检查诊断肺部恶性肿瘤的价值较高(AUC=0.910,95%CI:0.865~0.955),优于常规CT检查(AUC=0.759);常规CT检查CT值≥26.77 HU为恶性指征,诊断价值中等。能谱CT参数静脉期NIC诊断肺部恶性肿瘤的AUC为0.868,高于其他能谱CT参数。结论与常规CT检查相比,能谱CT检查对肺部肿瘤良恶性的鉴别诊断价值较高,且静脉期NIC的诊断价值高于其他能谱CT参数,可为临床肺部肿瘤良恶性的诊断提供参考。Objective To study the differential diagnostic value of energy spectral CT examination in benign and ma-lignant lung tumors.Method A total of 156 patients with lung tumors underwent conventional multi-slice spiral CT and energy spectrum CT examinations.According to the pathological examination results,they were divided into benign group(n=53)and malignant group(n=103).The conventional CT value and energy spectrum CT quantitative parameters[slope K,normalized iodine concentration(NIC)in arterial phase and venous phase]were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated,and the differential diagnostic value of conventional CT and energy spectrum CT examinations in benign and malignant lung tumors were evaluated.Result The conventional CT value,NIC in arterial phase,NIC in venous phase and slope K in the malignant group were significantly higher than those in the benign group,the differences were statistically signifi-cant(P<0.01).The diagnostic value of energy spectrum CT examination for lung malignant tumors was relatively high(AUC=0.910,95%CI:0.865-0.955),which was superior to conventional CT examination(AUC=0.759).Conventional CT value≥26.77 HU was the indication of malignancy in the diagnosis of pulmonary malignant tumors by conventional CT examination,and the diagnostic value was moderate.The AUC of energy spectral CT parameter NIC in venous phase in diagnosis of lung malignant tumors was 0.868,and the diagnostic value was moderate.Conclusion Compared with conventional CT examination,energy spectrum CT examination has high differential diagnostic value for benign and ma-lignant lung tumors,and the diagnostic value of NIC in venous phase is higher than other energy spectral CT parameters,which can provide reference for the clinical examination of benign and malignant lung tumors.

关 键 词：能谱CT 肺部肿瘤 标准化碘浓度 

分 类 号：R734.2[医药卫生—肿瘤]