能谱CT在中心气道鳞癌与腺样囊性癌鉴别诊断中的应用研究

目的:通过对中心气道原发鳞状细胞癌(SCC)与腺样囊性癌(ACC)的CT能谱扫描及多参数定量测量,探讨CT能谱成像在二者鉴别诊断中的初步应用价值。方法:选取未经任何治疗、行宝石能谱CT检查的中心气道SCC、ACC患者26例,SCC组14例,ACC组12例。符合增强条件者于平扫及动脉期行能谱扫描,将原始数据进行能谱分析,选取肿瘤实性部分作为测量感兴趣区,测量其平扫时40keV的CT值、钙含量和水含量;增强扫描动脉期40keV的CT值、碘含量、水含量,并计算平扫及动脉期相应能谱曲线斜率。采用独立样本t检验分析平扫及动脉期各参数在各组间有无统计学意义。结果:平扫时,SCC组40keV对应CT值、能谱曲线斜率、钙含量均大于ACC组,差异有统计学意义(P<0.05),水含量在两组间的差异无统计学意义(P>0.05)。增强扫描动脉期:SCC组40keV下CT值、能谱曲线斜率、碘含量均高于ACC组,差异有统计学意义(P<0.05),水含量间差异无统计学意义(P>0.05)。结论:CT能谱成像可作为中心气道原发SCC与ACC鉴别诊断的一种新方法,具有一定临床应用价值。

The Application of CT Spectrum Imaging for Diagnosis of Squamous Cell Carcinoma and Adenoid Cystic Carcinoma in Central Airway

Objectives: To investigate the preliminary application of spectral CT on the differential diagnosis between squamous cell carcinoma(SCC) and adenoid cystic carcinoma(ACC) of the primary central airway tumors by spectral CT scan and multi-parameter quantitative measurement. Methods: Choose the patients who were found with central airway tumors and without any treatment to take the gemstone spectral CT examination. We choose the patients who can comply with the conditions of enhancement to take plain scan and enhancement scan in arterial phase on GSI mode. All the data was processed by GSI Viewer software. The lump substance composition was selected as region of interest, measuring iodine concentration, water concentration and corresponding CT value of 40 ke V, Then calculate the corresponding slope of spectral curve, 26 patients were divided into SCC group and ACC group. Independent samples t test was used to analysis whether the parameters of plain scanning and arterial phase scanning have statistical significance. Results: Plain scan: Corresponding CT value at 40 ke V, energy spectrum curve slope, calcium content of SCC group was higher than those of ACC group, the difference was statistically significant(P<0.05), there was no significant difference in the water content in the two groups(P>0.05). Arterial phase enhanced scan: CT value at 40 ke V, the slope of the energy spectrum curve, iodine content of SCC group were higher than those of ACC group, the difference was statistically significant(P<0.05), there was no significant difference between the water content(P>0.05). Conclusions: Spectrum CT imaging can provide more quantitative and qualitative information for central airway primary tumor diagnosis. It can be used as a new method for diagnosis, and has certain clinical application value.