武卫杰,岳松伟,吕培杰,王会霞,吕东博,高剑波.能谱CT平扫多参数成像判断纯磨玻璃密度肺腺癌病理亚型[J].中国医学影像技术,2020,36(6):858~862
能谱CT平扫多参数成像判断纯磨玻璃密度肺腺癌病理亚型
Spectral CT plain multi-parameter imaging in differentiating pathological subtypes of pure ground glass opacity lung adenocarcinoma
投稿时间:2019-08-09  修订日期:2019-10-17
DOI:10.13929/j.issn.1003-3289.2020.06.013
中文关键词:  肺肿瘤  腺癌  癌,原位  体层摄影术,X线计算机  磨玻璃影
英文关键词:lung neoplasms  adenocarcinoma  carcinoma in situ  tomography, X-ray computed  ground-glass opacity
基金项目:
作者单位E-mail
武卫杰 郑州大学第一附属医院放射科, 河南 郑州 450052  
岳松伟 郑州大学第一附属医院放射科, 河南 郑州 450052 ysw197281@sina.com 
吕培杰 郑州大学第一附属医院放射科, 河南 郑州 450052  
王会霞 郑州大学第一附属医院放射科, 河南 郑州 450052  
吕东博 郑州大学第一附属医院放射科, 河南 郑州 450052  
高剑波 郑州大学第一附属医院放射科, 河南 郑州 450052  
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中文摘要:
      目的 探讨能谱CT平扫多参数成像判断纯磨玻璃密度结节(pGGN)肺腺癌病理亚型的价值。方法 回顾性分析45例接受能谱CT平扫并经病理证实的pGGN肺腺癌,将其分为A组[非IAC组,21例,包括9例原位腺癌(AIS)和12例微浸润腺癌(MIA)]和B组[浸润性腺癌(IAC)组,24例]。基于联合40%自适应统计迭代重建(ASIR-V)技术重建的70 keV单能水平图像评估pGGN的CT征象,包括分叶征、毛刺征、空泡征、空气支气管征及胸膜凹陷征和异常血管征;获取定量分析成像参数,包括40~140 keV单能量CT值、水基值(WC)、有效原子序数(Eff-Z)及能谱曲线斜率k1~k3(分别为40~70 keV、71~100 keV、101~140 keV段能谱曲线斜率)。结果 B组异常血管征出现率高于A组(P<0.05)。组间分叶征、毛刺征、空气支气管征、空泡征及胸膜凹陷征差异均无统计学意义(P均>0.05)。B组k1低于A组(P<0.05),而组间k2、k3差异均无统计学意义(P均>0.05)。B组WC高于A组(P<0.05),但2组间Eff-Z差异无统计学意义(P>0.05)。结论 能谱CT平扫多参数成像可在显示pGGN形态学表现的基础上提供多种定量参数和较常规CT更多的诊断信息,有助于判断pGGN肺腺癌的病理亚型。
英文摘要:
      Objective To explore the value of spectral CT plain multi-parameter imaging in judging pathological subtypes of lung adenocarcinoma with pure ground glass nodule (pGGN). Methods Forty-five patients with pathological confirmed lung adenocarcinoma manifested as pGGN on spectral plain CT scan images were included and divided into group A (non IAC group, including 9 patients of situ adenocarcinoma[AIS] and 12 of microinvasive adenocarcinoma[MIA]) and group B (invasive adenocarcinoma group, including 24 IAC patients). Monochromatic images at 70 keV with 40% adaptive statistical iterative reconstruction V (ASIR-V) were reconstructed and qualitative analyzed, including the lobulated sign, burr sign, vacuole sign, air bronchial sign as well as pleural indentation sign and abnormal vascular sign. Quantitative parameters, including CT values on monochromatic images raining from 40 keV to 140 keV, water concentration (WC), effective atomic number (Eff-Z) and spectral curve slope of k1-k3 (represent the slope of 40-70 keV, 71-100 keV, 101-140 keV respectively) were obtained and compared between 2 groups. Results The occurrence rate of abnormal vascular sign in group B was higher than that in group A (P<0.05), but there was no significant difference of lobulated sign, burr sign, air bronchial sign, vacuole sign nor pleural indentation sign between 2 groups (all P>0.05). The k1 in group B was lower than that in group A (P<0.05), but there was no significant difference of k2, k3 between groups (both P>0.05). The WC of group B was higher than that of group A (P<0.05), but there was no significant difference of Eff-Z between groups (P>0.05). Conclusion Spectral CT plain multi-parameter imaging can provide a variety of quantitative parameters based on the morphological features of pGGN and more diagnostic information than routine CT, which is helpful to judging pathological subtypes of lung adenocarcinoma manifested as pGGN.
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