| 张国晋,李昇霖,孔维芳,尚兰,任嘉梁,张凤,黄子昕,周俊林,蒲红.能谱CT多参数成像鉴别孤立性肺结核与肺腺癌[J].中国医学影像技术,2023,39(1):42~47 |
| 能谱CT多参数成像鉴别孤立性肺结核与肺腺癌 |
| Spectral CT multi-parameter imaging for differentiating solitary lesion of pulmonary tuberculosis and lung adenocarcinoma |
| 投稿时间：2022-08-10 修订日期：2022-09-28 |
| DOI：10.13929/j.issn.1003-3289.2023.01.009 |
| 中文关键词: 肺肿瘤|结核,肺|肺腺癌|诊断,鉴别|体层摄影术,X线计算机 |
| 英文关键词:lung neoplasms|tuberculosis, pulmonary|adenocarcinoma of lung|diagnosis, differential|tomography, X-ray computed |
| 基金项目:四川省干部保健科研项目(川干研2022-208)。 |
| 作者 | 单位 | E-mail | | 张国晋 | 电子科技大学附属医院·四川省人民医院放射科, 四川 成都 610072
甘肃省医学影像重点实验室, 甘肃 兰州 730030 | | | 李昇霖 | 甘肃省医学影像重点实验室, 甘肃 兰州 730030
兰州大学第二医院放射科, 甘肃 兰州 730030 | | | 孔维芳 | 电子科技大学附属医院·四川省人民医院放射科, 四川 成都 610072 | | | 尚兰 | 电子科技大学附属医院·四川省人民医院放射科, 四川 成都 610072 | | | 任嘉梁 | 通用电气药业(上海)有限公司, 上海 210000 | | | 张凤 | 电子科技大学附属医院·四川省人民医院放射科, 四川 成都 610072 | | | 黄子昕 | 电子科技大学附属医院·四川省人民医院放射科, 四川 成都 610072 | | | 周俊林 | 甘肃省医学影像重点实验室, 甘肃 兰州 730030
兰州大学第二医院放射科, 甘肃 兰州 730030 | | | 蒲红 | 电子科技大学附属医院·四川省人民医院放射科, 四川 成都 610072 | pqs19951211@126.com |
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| 中文摘要: |
| 目的 观察能谱CT多参数成像鉴别孤立性肺结核(SPT)与孤立性肺腺癌(SLA)的价值。方法 回顾性分析经病理证实的60例SPT (SPT组)及120例SLA (SLA组)患者的胸部能谱CT增强扫描图像,观察动、静脉期CT 70 keV单能量图像,测量病灶CT值(CT40 keV、CT70 keV)、有效原子序数(Zeff)、碘浓度(IC)及水浓度(WC),计算能谱曲线斜率(λ70 keV);比较各能谱CT参数的组间差异,针对差异有统计学意义的参数绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估以各单一参数及联合参数鉴别SPT与SLA的效能。结果 组间增强动、静脉期病灶CT40 keV、CT70 keV、Zeff、IC及λ70 keV差异均有统计学意义(P均<0.05),WC差异均无统计学意义(P均＞0.05)。增强动、静脉期各单一能谱CT参数中,CT40 keV鉴别SPT与SLA的AUC分别为0.80和0.81;以增强动或静脉期各参数联合诊断的AUC分别为0.84和0.83,高于同期各单一参数(Z=1.23~5.30,P均<0.05);联合增强动、静脉期能谱CT参数的AUC为0.91,高于联合增强动或静脉期能谱CT参数的AUC (Z=－2.74、－3.46,P均<0.01),联合增强动脉期参数与联合增强静脉期参数AUC差异无统计学意义(Z=0.26,P=0.79)。结论 能谱CT多参数成像可有效鉴别SPT与SLA。 |
| 英文摘要: |
| Objective To investigate the value of spectral CT multi-parameter imaging for differentiating solitary pulmonary tuberculosis (SPT) and solitary lung adenocarcinoma (SLA). Methods Chest spectral CT images of 60 patients with SPT (SPT group) and 120 patients with SLA (SLA group) confirmed by pathology were retrospectively analyzed. Then 70 keV CT images in the arterial and venous phase were reviewed, CT values (CT40 keV, CT70 keV), effective atomic number (Zeff), iodine concentration (IC) and water concentration (WC) of the lesions were measured and compared between groups, respectively, and the slope (λ70 keV) of the energy spectrum curve were calculated. Receiver operating characteristic (ROC) curve of parameters being significantly different between groups were drawn, and the area under the curves (AUC) were calculated to evaluate the efficacy of each single parameter and combining parameters for differentiating SPT and SLA. Results There were significant differences of CT40 keV, CT70 keV, Zeff, IC and λ70 keV of the lesions in the arterial and venous phase between groups (all P<0.05), but not of WC (both P＞0.05). Among single energy spectrum CT parameters of arterial or venous phase, AUC of CT40 keV in differentiating SPT and SLA was 0.80 and 0.81, while AUC of combining arterial parameters or combining venous phase parameters was 0.84 and 0.83, respectively, higher than that of each single parameter in the same phase (Z=1.23—5.30, all P<0.05). AUC of combination of all arterial and venous phase parameters was 0.91, higher than that of combining arterial or venous phase parameters (Z=－2.74, -3.46, both P<0.01). There was no significant difference of AUC between combining arterial phase parameters and combining venous phase parameters (Z=0.26, P=0.79). Conclusion Spectral CT multi-parameter imaging could effectively differentiate SPT and SLA. |
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