双源CT对不同病理分型肺癌与其转移淋巴结同源性研究

目的 探讨双源CT的CT值、碘浓度及能量衰减曲线斜率评价肺癌与其转移淋巴结同源性的价值。方法 对90例病理分型不同的肺癌患者行双源CT平扫及增强，获得碘基图和能量衰减曲线。比较鳞癌、腺癌及小细胞肺癌与其转移淋巴结的CT值、碘浓度及能量衰减曲线斜率。结果 鳞癌与其转移淋巴结于动脉期和静脉期的CT值、碘浓度、标准化碘浓度及能量衰减曲线斜率差异均无统计学意义（P均 > 0.05）。腺癌与其转移淋巴结于动脉期的CT值、碘浓度、标准化碘浓度及能量衰减曲线斜率差异均无统计学意义（P均 > 0.05）；静脉期CT值及能量衰减曲线斜率差异均无统计学意义（P均 > 0.05），而碘浓度和标准化碘浓度差异有统计学意义（P均 < 0.05）。小细胞肺癌与其转移淋巴结于动脉期和静脉期的CT值及能量衰减曲线斜率差异均无统计学意义（P均 > 0.05），动脉期的碘浓度及标准化碘浓度差异均无统计学意义（P均 > 0.05），静脉期的碘浓度和标准化碘浓度差异均有统计学意义（P均 < 0.05）。结论 动脉期肺癌与其转移淋巴结具有同源性，双源CT可用于早期鉴别诊断转移但尚未肿大的淋巴结。

Homologic study between different molecular pathological types of lung cancer and its metastatic lymph nodes using dual-source CT

Objective To investigate CT value, iodine concentration (IC), normalized iodine concentration (NIC) and energy attenuation curve slope of dual-source CT in exploring homology of lung cancer and metastatic lymph nodes. Methods Totally 90 cases of different pathological types of lung cancer underwent dual-energy CT scaning, and the iodine maps and energy decay curves were obtained. The CT value, IC, NIC and energy decay curves slopes were compared between squamous carcinoma, adenocarcinoma and small cell lung cancer with metastatic lymph nodes. Results The CT values, IC, NIC and energy decay curves slopes between squamous carcinoma and metastatic lymph nodes in arterial and venous phases had no significant differences (all P>0.05). The CT value, IC, NIC and energy decay curves slopes between adenocarcinoma and lymph nodes in arterial phase had no significant differences (all P>0.05). The CT value and energy curves slopes had no significant differences in venous phase (all P>0.05), but IC and NIC had significant differences (both P<0.05). In small cell lung cancer and metastatic lymph nodes, the CT value, energy curves slopes had no significant differences in both artery and venous phases (all P>0.05). In artery phase, IC and NIC had no statistical significant differences (all P>0.05), while in venous phase, IC and NIC had statistically significant differences (all P<0.05). Conclusion Pulmonary lung cancer and metastatic lymph nodes are homologous, and dual-source CT can be used for early differential diagnosis of metastatic without swollen lymph node.