一站式能谱及灌注成像鉴别诊断孤立性肺结节

目的：探讨一站式能谱及灌注成像在孤立性肺结节(SPN)鉴别诊断中的应用价值。方法47例接受一站式能谱及灌注成像且经病理证实为 SPN 患者分为恶性组(28例)、良性组(19例)，分别测量肺内病灶的血容量(BV)、血流量(BF)、平均通过时间(MTT)、表面通透性(PS)数值及动、静脉期的碘浓度(IC)、标准碘浓度(NIC)、能谱曲线斜率(40~100 keV)。采用独立样本 t 检验的方法，比较2组各参数间的差异。结果恶性结节的灌注参数 BF、BV、PS 值高于良性结节，有显著性差异(P <0.05)，恶性结节 MTT 与良性结节无显著性差异(P>0.05)；肺恶性结节动、静脉期 IC、NIC、能谱曲线斜率均高于良性结节，有显著性差异(P<0.05)。结论一站式能谱及灌注成像技术具有实现能谱及灌注成像同时完成的优势，可提供更多参数，在 SPN 鉴别诊断中具有一定应用价值。

Diagnosis of solitary pulmonary nodule by one-step spectral and perfusion imaging

Objective To observe the value of one-step spectral imaging and perfusion imaging in diagnosis of solitary pulmonary nodule(SPN).Methods Forty-seven patients with SPN proved by pathology underwent perfusion scan with gemstone spectral ima-ging mode,who were divided into malignant group in 28 patients and benign one in 1 9.The parameters of CT perfusion including blood volume (BV),blood flow (BF),mean transit time (MTT)and permeability surface (PS)were analyzed.Iodine concentration (IC),normalized iodine concentration (NIC)and slope rate of spectral curve in both arterial phase and venous phase were measured and calculated.The independent sample t test was performed to compare quantitative parameters between malignant and benign SPN.Results BF,BV and PS of malignant SPN were higher than those of benign ones (P <0.05).No statistically significantly differences between malignant and benign SPN were found (P >0.05).IC,NIC and slope rate of spectral curve in malignant SPN were higher than those in benign ones in both phases (P <0.05).Conclusion One-step spectral imaging and perfusion imaging can provide more parameters,which is helpful for the diagnosis of SPN.