能谱CT鉴别孤立性肺结节性质的效能  

Efficiency of Spectral CT in Differentiating the Properties of Solitary Pulmonary Nodule

作　　者：戴晓龙 陆兵[2] 黄健[3] 许俊华 DAI Xiao-long;LU Bing;HUANG Jian;XU Jun-hua(Department of Thoracic Surgery,Taicang Hospital of Traditional Chinese Medicine,Taicang 215400,Jiangsu Province,China;Department of Pulmonary and Critical Care Medicine,Taicang Hospital of Traditional Chinese Medicine,Taicang 215400,Jiangsu Province,China;Department of Radiology,Taicang Hospital of Traditional Chinese Medicine,Taicang 215400,Jiangsu Province,China)

机构地区：[1]太仓市中医医院胸外科,江苏太仓215400 [2]太仓市中医医院呼吸与危重症医学科,江苏太仓215400 [3]太仓市中医医院放射科,江苏太仓215400

出　　处：《中国CT和MRI杂志》2025年第3期79-82,共4页Chinese Journal of CT and MRI

基　　金：苏州市科技发展计划项目(SYSD2020113)。

摘　　要：目的探讨能谱CT多参数联合形态学特征对肺孤立性结节(SPN)的诊断效能。方法选取2021年1月至2023年12月我院收治的80例SPN患者,依据病理性质分为恶性组(n=49)与良性组(n=31),分析患者基线资料、CT形态学特征评分以及能谱CT多参数,探究其对SPN的诊断效能。结果恶性组SPN毛刺征和棘突征、分叶征等CT形态学特征评分以及总分均高于良性组(P<0.05)。恶性组动脉期(AP)、静脉期(VP)标准化碘浓度(NIC)高于良性组(P<0.05);恶性组在AP 40 keV、70 keV、100 keV、140 keV能量水平CT值高于良性组(P<0.05),在VP 40 keV、70 keV、100 keV能量水平CT值高于良性组(P<0.05);恶性组在AP 40 keV~70 keV区间能谱曲线斜率高于良性组(P<0.05),在VP 40 keV~70 keV、70 keV~100 keV区间能谱曲线斜率高于良性组(P<0.05)。受试者工作特征曲线显示,AP NIC、VP NIC、AP在40 keV、70 keV、100 keV、140 keV能量水平CT值、VP在40 keV、70 keV、100 keV能量水平CT值、VP在40~70 keV区间能谱曲线斜率、CT形态学特征评分以及联合对SPN良恶性均有一定的诊断效能(P<0.05),其曲线下面积分别为0.764、0.665、0.770、0.658、0.734、0.779、0.673、0.723、0.700、0.720、0.922、0.625,其中CT形态学特征评分诊断效能最高,敏感性为73.47%,特异性为96.77%。结论恶性SPN CT形态学特征评分、NIC、单能量CT值、能谱曲线斜率均显著高于良性SPN,可利用能谱CT多参数联合形态学特征诊断SPN良、恶性,其中CT形态学特征诊断效能最高。Objective To explore the diagnostic efficiency of spectral CT multi-parameters combined with morphological characteristics on solitary pulmonary nodule(SPN).Methods 80 patients with SPN in our hospital from January 2021 to December 2023 were selected and divided into malignant group(n=49)and benign group(n=31)according to the pathological properties.The baseline data,CT morphological characteristics scores and spectral CT multi-parameters were analyzed,and the diagnostic efficiency on SPN was explored.Results The scores of CT morphological characteristics such as SPN spicule sign,spinous process sign and lobulation sign and total score in malignant group were higher than those in benign group(P<0.05).The normalized iodine concentrations(NICs)of arterial phase(AP)and venous phase(VP)in malignant group were higher compared with those in benign group(P<0.05).The CT values of AP at 40 keV,70 keV,100 keV and 140 keV in malignant group were higher(P<0.05),and the CT values of VP at 40 keV,70 keV and 100 keV were higher than those in benign group(P<0.05).The slope of energy spectrum curve of AP at 40 keV-70 keV in malignant group was higher than that in benign group(P<0.05),and the slopes of energy spectrum curve of VP at 40 keV-70 keV and 70 keV-100 keV were higher compared to benign group(P<0.05).Receiver operating characteristic curve showed that AP NIC,VP NIC,CT values of AP at 40 keV,70 keV,100 keV and 140 keV,CT values of VP at 40 keV,70 keV and 100 keV,slope of energy spectrum curve of VP at 40-70 keV,CT morphological characteristic score and combination had certain diagnostic efficiency on benign and malignant SPN(P<0.05),and the areas under the curves were 0.764,0.665,0.770,0.658,0.734,0.779,0.673,0.723,0.700,0.720,0.922 and 0.625 respectively.The diagnostic efficiency of CT morphological characteristics scores was the highest,with a sensitivity of 73.47%and a specificity of 96.77%.Conclusion The CT morphological characteristics scores,NIC,single energy CT value and energy spectrum curve slope of malignant SPN

关 键 词：能谱CT 形态学特征 肺孤立性结节 诊断 

分 类 号：R563[医药卫生—呼吸系统]