宝石能谱CT成像在不同病理类型肺癌分类诊断的价值探讨

目的:宝石能谱CT成像技术在不同病理类型肺癌中鉴别诊断的价值。方法:回顾性分析106例经病理证实的肺癌患者的能谱CT资料,选取动脉期扫描参数,行能谱数据分析。结果:肺鳞癌组、肺腺癌组、肺小细胞肺癌组、肺大细胞肺癌组的NIC分别为:0.07±0.03、0.12±0.06、0.05±0.03、0.05±0.02;钙含量(mg/mL)分别为9.59±5.29、5.83±3.84、2.65±1.47、4.08±1.55,水含量(mg/mL)分别为1060.63±34.87、1038.56±28.36、1040.88±17.83、1036.84±8.26;有效原子序数分别为7.87±0.27、8.01±0.31、7.73±0.32、7.90±0.46;40~80Kev能谱曲线斜率分别为0.77±0.49、1.28±0.68、0.29±0.14、0.44±0.28。各组动脉期的NIC和钙(水)基含量、有效原子序数、40~80keV间的能谱衰减曲线斜率比较差异均有统计学意义(P<0.05)。动脉期鳞癌组、肺腺癌组、肺小细胞肺癌组、肺大细胞肺癌组的NIC两两比较差异有统计学意义(P<0.05);肺鳞癌组的水含量与肺腺癌组、肺小细胞肺癌组、肺大细胞肺癌组之间比较差异有统计学意义(P<0.05);肺鳞癌组与肺腺癌组、小细胞肺癌组、大细胞肺癌组及肺腺癌组与肺小细胞肺癌组之间钙含量比较差异有统计学意义(P<0.05);肺鳞癌组与肺腺癌组及肺腺癌组与肺小细胞肺癌组之间的有效原子序数比较差异有统计学意义(P<0.05);肺鳞癌组与肺腺癌组、小细胞肺癌组及肺腺癌组与肺小细胞肺癌组、大细胞肺癌组的40~80keV能谱衰减曲线斜率之间比较差异有统计学意义(P<0.05)。结论:原发病灶的能谱CT特征参数,对不同病理类型及组织来源肺癌的鉴别诊断有着一定的临床指导意义。 

The Value of Spectral CT Image in the Diagnosis of Different Pathological Types of Lung Cancer

Objective:To study the application value of analysis in distinguishing different pathological types of lung cancer by gemstone spectral imaging.Methods:Retrospective analysis of 106 patients with lung cancer (including small cell lung cancer,lung adenocarcinoma,lung squamous cell carcinoma,large cell lung cancer) confirmed by pathology.The gemstone spectral imaging data were analyzed.Results:The NIC and Calcium content,water content,effectiv-Z,slope rate of spectral curv of squamous carcinoma group and adenocarcinoma group,small cell carcinoma group,large cell lung cancer were0.07 ± 0.03,0.12 ± 0.06,0.05 ± 0.03,0.05 ± 0.02,9.59±5.29,5.83 ±3.84,2.65 ± 1.47,4.08 ± 1.55,1060.63 ±34.87,1038.56±28.36,1040.88 ± 17.83,1036.84 ± 8.26,7.87 ± 0.27,8.01 ± 0.31,7.73 ± 0.32,7.90 ± 0.46,0.77 ± 0.49,1.28 ± 0.68,0.29 ± 0.14,0.44 ± 0.28 (P ＜ 0.05).As for the result of LSD-t,There was statistically significant of NIC in each groups (P ＜ 0.05);There was statistically significant of water content in squamous carcinoma group and adenocarcinoma group,small cell carcinoma group,large cell lung cancer (P ＜ 0.05);There was statistically significant of Calcium content in not only squamous carcinoma group and adenocarcinoma group,small cell carcinoma group,large cell lung cancer group,but adenocarcinoma group and small cell carcinoma group (P ＜ 0.05);There was statistically significant of Effective-Z in not only squamous carcinoma group and adenocarcinoma group,but adenocarcinoma group and small cell carcinoma group (P ＜ 0.05);There was statistically significant of slope rate of spectral curv in not only squamous carcinoma group and adenocarcinoma group,small cell carcinoma group,but adenocarcinoma group and small cell carcinoma group and large cell carcinoma group (P ＜ 0.05).Conclusion:Spectral CT imaging has certain clinical significance in diagnosing different pathological types of lung cancer.