武卫杰,岳松伟,吕培杰,王会霞,吕东博,高剑波.能谱CT平扫多参数成像在鉴别纯磨玻璃密度肺腺癌病理亚型中的价值[J].中国医学影像技术,2020,36(6):
能谱CT平扫多参数成像在鉴别纯磨玻璃密度肺腺癌病理亚型中的价值
The value of 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:2020-06-14
DOI:
中文关键词:  能谱CT 纯磨玻璃密度结节  原位腺癌 微浸润腺癌  浸润性腺癌
英文关键词:spectral CT, pure ground-glass nodule, adenocarcinoma in situ, minimally invasive adenocarcinoma, invasive adenocarcinoma
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作者单位E-mail
武卫杰 郑州大学第一附属医院 1195653583@qq.com 
岳松伟* 郑州大学第一附属医院放射科 ysw197281@sina.com 
吕培杰 郑州大学第一附属医院放射科  
王会霞 郑州大学第一附属医院放射科  
吕东博 郑州大学第一附属医院放射科  
高剑波 郑州大学第一附属医院放射科  
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中文摘要:
      目的 探讨能谱CT平扫多参数成像在鉴别纯磨玻璃密度结节(pGGN)肺腺癌病理亚型中的价值。 方法 回顾性分析于我院接受能谱CT平扫并经病理证实为pGGN肺腺癌的患者45例,分为A组[原位腺癌(AIS) 9例及微浸润腺癌(MIA)12例]和B组[浸润性腺癌(IA)24例]。所有组别结节的定性CT征象评估基于联合40%ASIR-V迭代技术重建的70keV单能水平图像,包括结节的分叶征、毛刺征、空泡征、空气支气管征、胸膜凹陷征和异常血管征。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(k1~k3分别为40~70keV、70~100keV、100~140keV段能谱曲线斜率)。采用独立样本 t 检验、 Mann-Whitney U 检验及c2检验进行统计分析。 结果 血管征在两组间差异有统计学意义(P<0.05),而分叶征、毛刺征、空气支气管征、空泡征、胸膜凹陷征在两组间差异均无统计学意义(均P>0.05)。B组40~70 keV能谱曲线斜率低于A组(P<0.05),而两组间70-100keV、100-140keV段能谱曲线斜率差异无统计学意义(均P>0.05)。B组WC高于A组(P<0.05),而两组间Eff-Z差异无统计学意义(P>0.05)。 结论 能谱CT平扫可以在提供pGGN形态学征象的基础上获得多种定量参数,提供更多的诊断信息,有助于提高pGGN肺腺癌病理亚型的鉴别诊断。
英文摘要:
      Objective To investigate the value of spectral CT plain multi-parameter imaging in the identification of pathological subtypes of lung adenocarcinoma with pure ground glass nodule (pGGN). Methods Forty-five patients with pathological confirmed pGGN lung adenocarcinoma underwent spectral plain CT scan were included retrospectively and divided into group A (n=9, situ adenocarcinoma [AIS]; n=12, microinvasive adenocarcinoma [MIA]) and group B (n=24 ,invasive adenocarcinoma [IA]) respectively. Monochromatic images at 70keV with 40% adaptive statistical iterative reconstruction V (ASIR-V) were reconstructed for qualitative analyses, including the lobulated sign, the burr sign, the vacuole sign, the air bronchial sign, the pleural indentation sign and the abnormal vascular sign. Quantitative analyses of parameters included 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 (k1 ~ k3 represent the slope of 40~70 keV, 70~100 keV, 100~140 keV respectively).The data were analyzed using independent sample t test, Mann-Whitney U test and c2 test. Results There were significant differences in the abnormal vascular sign between the two groups (P<0.05), but there were no significant differences between the two groups in the lobulated sign, burr sign, air bronchial sign, vacuole sign, and pleural indentation sign (P> 0.05).Spectral curve slope of k1 in group B was lower than that in group A (P<0.05), but there was no significant difference in the spectral curve slope of k2 ~ k3 in two groups (P>0.05).The WC of group B was higher than that of group A (P<0.05), but the difference of Eff-Z between the two groups was not statistically significant (P>0.05). Conclusion The spectral CT plain can obtain a variety of quantitative parameters based on the morphological features of pGGN, provide more diagnostic information, and help to improve the differential diagnosis of pathological subtypes of pGGN lung adenocarcinoma.
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