Ⅲ期非小细胞肺癌患者放疗所致放射性肺炎CT特点及识别  

CT Features and Identiffcation of Radiation Pneumonia Caused by Radiotherapy in Patients with StageⅢNon-small Cell Lung Cancer

作　　者：罗楠 钱柳 海丽且姆·艾力 阿娜尔古丽·奥斯曼 王靖喆 余莹莹[2] LUO Nan;QIAN Liu;HAILIQIEMU-Aili;ANAERGULI-Aosiman;WANG Jing-zhe;YU Ying-ying(Medical Imaging,the Third Clinical College of Xinjiang Medical University,Urumqi 830011,Xinjiang Uygur Autonomous Region,China;lmaging Center,Affliated Cancer Hospital of Xinjang Medical University,Urumqi 830011,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆医科大学第三临床医学院,新疆乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院影像中心,新疆乌鲁木齐830011

出　　处：《中国CT和MRI杂志》2025年第2期74-76,共3页Chinese Journal of CT and MRI

基　　金：新疆医科大学大学生创新训练计划项目(202210760037)。

摘　　要：目的 探讨Ⅲ期非小细胞肺癌(NSCLC)患者放疗所致放射性肺炎(RP)CT特点及识别效果。方法 回顾性分析2021年2月至2023年3月在我院接受放疗治疗的80例Ⅲ期NSCLC临床资料,依据放疗后是否出现RP分成RP组(n=31)与非RP组(n=49)。分析两组一般资料,分析RP能谱CT影像学表现,比较两组动脉期、静脉期能谱CT参数。结果 两组一般资料比较不具有统计学意义(P>0.05);RP急性期CT表现为边界不清的实变影,内可见肺纹理影,慢性期CT表现为跨肺叶肺段分布的条带及三角形致密阴影,边缘清晰,可见支气管充气征,同时能出现支气管扩张征象。动脉期RP组标准化碘浓度(NIC)、能谱曲线斜率(λHU)、有效原子序数(Effective-Z)及70keV单能量水平对应的△CT值(CT70 keV)均高于非RP组,静脉期RP组NIC、Effective-Z、λHU及CT70 keV值均低于非RP组,差异有统计学意义(P<0.05),但两组动脉期、静脉期标准化水浓度差异比较均不具有统计学意义(P>0.05)。结论 Ⅲ期NSCLC患者放疗所致RP的CT表现具有一定特点,为临床防治RP提供依据,可推广应用。Objective To investigate the CT features and identification of radiation pneumonia(RP) caused by radiotherapy in patients with stage Ⅲ non-small cell lung cancer(NSCLC). Methods The clinical data of 80 patients with stage Ⅲ NSCLC who underwent radiotherapy in the hospital from February 2021 to March 2023 were analyzed retrospectively. The patients were divided into RP group(n=31) and non-RP group(n=49) based on whether RP occurred after radiotherapy. General data of the two groups,and energy spectrum CT imaging manifestations of RP were analyzed. Energy spectrum CT parameters in arterial phase and venous phase were compared between the two groups. Results The general data of the two groups were similar(P>0.05). In the acute phase of RP, CT findings included consolidation with blurred boundaries, and lung markings. In the chronic phase, CT findings included strip and triangular dense shadows distributed across pulmonary lobes and segments, with clear edges. Air bronchogram and bronchiectasis were observed. The normalized iodine concentration(NIC), the slope of energy spectral attenuation curve(lambda HU), effective atomic number(Effective-Z) and 70. keV monoenergetic △CT value(CT_(70 keV)) in arterial phase of RP group were higher than those in the non-RP group. NIC, Effective-Z, λ HU and CT_(70 keV) in venous phase of RP group were lower than those in the non-RP group(P<0.05). There was no statistically significant difference in normalized water concentration in arterial phase and venous phase between the two groups(P>0.05). Conclusion CT manifestations of RP caused by radiotherapy in patients with stage Ⅲ NSCLC are characteristic, providing a basis for clinical prevention and treatment of RP.

关 键 词：非小细胞肺癌 放疗 放射性肺炎 CT 识别 

分 类 号：R563.1[医药卫生—呼吸系统]