双源CT增强多参数成像在肺结节诊断中的临床价值

目的 探讨双源CT增强多参数成像在肺结节诊断中的临床价值。方法 回顾性分析本院2018年10月—2021年12月间接受双源CT增强多参数成像检查患者51例，根据病理活检结果分为良性组（良性肺结节21例）和恶性组（恶性肺结节30例）。将双源CT增强多参数成像图像传入Siemens双源CT专用Dual-Energy软件，通过勾画感兴趣区记录结节不同keV时单能量CT值。比较两组患者双源CT增强多参数数据，同时绘制ROC曲线计算各参数鉴别诊断良恶性肺结节的阈值。结果 良性组患者的NIC、K绝对值、碘基值及常规增强CT值均明显高于恶性组(P<0.01)；良性组患者静脉期40、70、100、120及140keV下的CT值均明显高于恶性组(P<0.01)。ROC曲线分析显示，NIC的AUC面积明显高于K绝对值和碘基值(P<0.05)，NIC+K绝对值+碘基值联合诊断的AUC面积均明显高于单独诊断(P<0.05)。结论 双源CT增强多参数成像可作为肺结节良恶性鉴别诊断的有效影像学手段，具有多参数、可量化等优势，对肺结节早期诊断和治疗指导均具有重要意义

The clinical value of dual-source CT enhanced multi-parameter imaging in the diagnosis of pulmonary nodule

Objective To investigate the clinical value of dual-source CT enhanced multiple-parameter imaging in the diagnosis of pulmonary nodule. Methods A retrospective analysis of 51 patients undergoing dual-source CT from October 2018 to December 2021, including 21 patients diagnosed as benign lung nodules and 30 malignant lung nodules, which were treated as benign and malignant groups, respectively. Dual-source CT-enhanced multi-parametric imaging images were transmitted into the Siemens dual-source CT dedicated Dual-Energy software to record the single-energy CT values at different keV in the nodules by delineating the region of interest. Two-source CT-enhanced multiparameter data were compared, and ROC curves were simultaneously plotted to calculate the threshold for the differential diagnosis of benign and malignant lung nodules for each parameter. Results The NIC, K absolute, iodine base and conventional enhanced CT values in the benign group were significantly higher than those in the malignant group (P <0.01); the CT values at 40keV, 70keV, 100keV, 120keV and 140keV were significantly higher than those in the malignant group (P <0.01).The ROC curve analysis showed that the AUC of NIC was significantly higher than the absolute K and iodine base values (P<0.05), the AUC area of the combined absolute NIC + K value was significantly higher than the diagnosis alone (P <0.05). Conclusion Dual-source enhanced multi-parametric imaging by CT can be used as an effective imaging means for the differential diagnosis of benign and malignant tumors of pulmonary nodule, with the advantages of multiple parameters and quantifiable tumors, and is of great significance for the early diagnosis and treatment guidance of pulmonary nodule