能谱CT联合MRI-DWI在鉴别肺炎性结节与肺癌中的价值  

The value of energy spectrum CT combined with MRI-DWI in differentiating pulmonary inflammatory nodules from lung cancer

作　　者：贾艳荣[1] 张凤翔[1] 张芳[1] 徐彦东[1] 奇丽霞 杜海[1] JIA Yanrong;ZHANG Fengxiang;ZHANG Fang;XU Yandong;QI Lixia;DU Hai(Department of CT-MRI,Erdos Central Hospital,Erdos 017000,China)

机构地区：[1]内蒙古自治区鄂尔多斯市中心医院CT-MRI室,内蒙古鄂尔多斯017000

出　　处：《医学影像学杂志》2024年第11期57-61,共5页Journal of Medical Imaging

基　　金：内蒙古医科大学科技百万工程联合项目[编号:YKD2018KJBW(LH)094]。

摘　　要：目的探讨能谱CT联合MRI-DWI在鉴别肺炎性结节与肺癌中的价值。方法选取我院经病理或随访证实的肺炎性结节组与肺癌组患者各25例,均行宝石能谱CT成像(GSI)及MRI-DWI。采用统计学分析比较两组各能谱参数、ADC值的差异,ROC曲线分析各指标的诊断效能,P<0.05为差异有统计学意义。结果肺炎性结节与肺癌两组的Eff-Z、平扫CT值、动脉期CT值、静脉期CT值、动脉期标准化碘浓度(NIC)、静脉期NIC、静脉期净增IC(dIC)、动脉期净增CT值(dCT)、静脉期dCT的差异均有统计学意义(P<0.05),两组动脉期碘浓度(IC)、静脉期IC、动脉期dIC、动脉期λ40~90及静脉期λ40~90的差异均无统计学意义(P>0.05);两组间ADC值的差异有统计学意义(P<0.05);且不同b值情况下肺癌组ADC值均低于肺炎性结节组;随着b值的升高,肺癌组ADC值下降显著。能谱参数中静脉期dCT的诊断价值最高,AUC为0.848(0.718~0.934),敏感度为80%,特异度为92%;DWI扫描中b值1000的诊断价值最高,AUC为0.934(0.826~0.985),敏感度为96%,特异度为92%。两者联合诊断效能最佳。结论能谱CT及MRI-DWI在肺炎性结节与肺癌的鉴别诊断中有重要价值,两种检查方法联合能够提高鉴别诊断效能。Objective To investigate the value of energy spectrum CT combined with MRI-DWI in differentiating pulmonary inflammatory nodules from lung cancer.Methods Twenty five patients with pulmonary inflammatory nodules and 25 patients with lung cancer confirmed by pathology or follow-up were collected.All patients were scanned by gemenergy spectrum CT(GSI)and diffusion weighted MRI imaging(DWI).Statistical analysis was used to compare the differences of energy spectrum parameters and ADC values between the two groups,and ROC curve was employed to analyze the diagnostic efficacy of each index.P<0.05 was considered statistically significant.Results There were significant differences in Eff-Z,CT value of plain scan,CT value of arterial phase,CT value of venous phase,NIC of arterial phase,NIC of venous phase,dIC of venous phase,dCT of arterial phase and dCT of venous phase between the two groups(P<0.05).There were no significant differences in IC of arterial phase,IC of venous phase,dIC of arterial phase,λ40~90 of arterial phase andλ40~90 of venous phase between the two groups(P>0.05).The difference of ADC values between the two groups was statistically significant(P<0.05).ADC values of lung cancer group were lower than those of pulmonary inflammatory nodules group under different b values.With the increase of b value,ADC value in lung cancer group decreased significantly.The diagnostic value of venous phase dCT was the highest among energy spectrum parameters,with AUC of 0.848(0.718~0.934),sensitivity of 80%,and specificity of 92%.The diagnostic value of b value 1000 in DWI scan was the highest,with AUC of 0.934(0.826~0.985),sensitivity of 96%,and specificity of 92%.The combination of the two methods had the best diagnostic efficacy.Conclusion Energy spectrum CT and MRI-DWI have important value in the differential diagnosis of pulmonary inflammatory nodules and lung cancer.The combination of the two methods can improve the differential diagnosis efficiency.

关 键 词：能谱成像 炎症 肺癌 磁共振成像 

分 类 号：R734.2[医药卫生—肿瘤] R445.2[医药卫生—临床医学]