能谱CT定量分析联合动态增强CT扫描在肺癌病理类型诊断中的应用价值  

Quantitative energy spectrum CT combined with dynamic contrast-enhanced CT scanning for the diagnosis of pathological types of lung cancer

作　　者：孟欢 潘玉坤 张元立 朱合伟 Meng Huan;Pan Yukun;Zhang Yuanli;Zhu Hewei(Department of Radiology,Zhuamadian Traditional Chinese Medicine Hospital,Zhumadian 463000,China;Department of Radiology,Fuwai Central China Cardiovascular Hospital,Zhengzhou 450000,China)

机构地区：[1]驻马店市中医院放射科,驻马店463000 [2]阜外华中心血管病医院放射科,郑州450000

出　　处：《中国实用医刊》2025年第2期70-74,共5页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关计划项目(LHGJ20220122)。

摘　　要：目的探讨能谱CT定量分析联合动态增强CT扫描对肺癌病理类型的诊断价值。方法抽取2022年1月至2024年1月驻马店市中医院收治的113例肺癌患者,回顾性分析其临床资料。根据病理结果将纳入患者分为小细胞肺癌(SCLC)组(17例)和非小细胞肺癌(NSCLC)组(96例),其中NSCLC组又分为鳞癌组(41例)和腺癌组(55例)。比较不同病理类型肺癌患者动态增强CT定量参数(强化净增值、强化率、廓清率)、能谱CT定量参数[碘浓度(IC)、标准化碘浓度(NIC)、水浓度、能谱曲线斜率、有效原子序数]。绘制受试者工作特征曲线分析能谱CT定量参数联合动态增强CT定量参数诊断NSCLC与SCLC、腺癌与鳞癌的效能。结果SCLC组强化净增值低于NSCLC组,延迟扫描600 s时廓清率高于NSCLC组(P<0.05)。SCLC组NIC、能谱曲线斜率低于NSCLC组(P<0.05)。鳞癌组延迟扫描600 s时廓清率高于腺癌组(P<0.05)。鳞癌组NIC、能谱曲线斜率低于腺癌组(P<0.05)。绘制受试者工作特征曲线结果显示,能谱CT定量参数联合动态增强CT定量参数鉴别诊断NSCLC与SCLC的曲线下面积(AUC)>0.9,诊断效能较高(P<0.05);能谱CT定量参数联合动态增强CT定量参数鉴别诊断腺癌与鳞癌的AUC>0.7,具有中等诊断效能(P<0.05)。结论能谱CT与动态增强CT检查有助于鉴别诊断肺癌病理类型,且联合两者定量参数可提高诊断效能。Objective To investigate the value of quantitative energy spectrum computed tomography(CT)combined with dynamic contrast-enhanced CT scanning in differential diagnosis of pathological types of lung cancers.Methods A retrospective analysis was conducted on the clinical data of 113 lung cancer patients admitted to Zhumadian Traditional Chinese Medicine Hospital from January 2022 to January 2024.Based on pathological results,they were divided into the small cell lung cancer(SCLC)group(17 cases)and the non-small cell lung cancer(NSCLC)group(96 cases).Patients in the NSCLC group were further divided into the squamous cell carcinoma group(41 cases)and the adenocarcinoma group(55 cases).Dynamic contrast-enhanced CT quantitative parameters(added value of enhancement,enhancement rate,clearance rate)and energy spectrum CT quantitative parameters including iodine concentration(IC),standardized iodine concentration(NIC),water concentration,slope of energy spectrum curve and effective atomic number were compared among patients with different pathological types of lung cancer.Receiver operating characteristic curve was drawn to analyze the efficacy of energy spectrum CT quantitative parameters combined with dynamic enhanced CT in differential diagnosis of NSCLC and SCLC,as well as adenocarcinoma and squamous cell carcinoma.ResultsThe added value of enhancement in the SCLC group was lower than that in the NSCLC group,and the clearance rate after a 600-second delayed scan in the SCLC group was higher than the NSCLC group(P<0.05).The NIC and energy spectrum curve slope in the SCLC group were lower than those in the NSCLC group(P<0.05).The clearance rate after a 600-second delayed of the squamous cell carcinoma group was higher than that of the adenocarcinoma group(P<0.05).The NIC and energy spectrum curve slope of the squamous cell carcinoma group were lower than those of the adenocarcinoma group(P<0.05).The results of receiver operating characteristic curve plotted revealed that the area under the curve(AUC)of the combination of

关 键 词：肺癌 能谱CT 动态增强CT 病理类型 

分 类 号：R73[医药卫生—肿瘤]