CT能谱曲线鉴别诊断脊柱肿瘤及肿瘤样病变

目的探讨CT能谱曲线鉴别诊断脊柱恶性肿瘤与非恶性肿瘤及肿瘤样病变的价值。方法对38例经手术或穿刺病理证实的脊柱肿瘤及肿瘤样病变患者行能谱CT扫描,包括非恶性组18例,其中良性和中间型肿瘤及肿瘤样病变分别为12例和6例;恶性组20例。获得单能量图像,生成CT能谱曲线,计算40~140keV不同能级水平下的CT值和能谱曲线斜率。同时获得病变在混合能量图像的静脉期CT值。对所得CT值和能谱曲线斜率进行统计学分析。结果 40~80keV非恶性组CT值分别为(197.97±95.69)HU、(141.30±63.66)HU、(105.78±44.04)HU、(84.21±32.65)HU、(68.92±26.16)HU,恶性组CT值分别为(321.86±97.97)HU、(225.46±72.42)HU、(159.98±50.03)HU、(120.53±41.69)HU、(96.59±37.86)HU。40~80keV条件下,非恶性组与恶性组相同能级CT值差异均有统计学意义(P均<0.05);90~140keV条件下,非恶性组与恶性组相同能级CT值差异均无统计学意义(P均>0.05)。非恶性组能谱曲线斜率为1.58±0.89,低于恶性组能谱曲线斜率(2.76±0.83;t=-3.48,P=0.002)。非恶性组与恶性组混合能量图像的CT值差异无统计学意义(t=-1.19,P=0.250)。结论 CT能谱曲线对鉴别恶性与非恶性脊柱肿瘤及肿瘤样病变有一定价值,具有较好的应用前景。

CT spectral curve in differentiating malignant vertebral tumorsfrom non-malignancies

Objective To evaluate the value of CT spectral curve in differentiating malignant vertebral tumors (MVT) from non-malignant vertebral tumors and tumor-like lesions (NMVT). Methods Totally 38 patients with vertebral tumors and tumor-like lesions proved pathologically by surgery or biopsy underwent spectral CT scan and were divided into MVT group (n=20) and NMVT group (n=18, including 12 cases of benign tumors and tumor-like lesions, 6 cases of intermediate tumors). The monochromatic images were measured and the CT spectral curves were obtained. The attenuation values at different energy levels (40-140 keV), CT values of lesions on the conventional CT images and the gradient of curve were measured and compared between MVT and NMVT groups. Results CT values of NMVT group at 40~80 keV were separately (197.97±95.69)HU, (141.30±63.66)HU, (105.78±44.04)HU, (84.21±32.65)HU and (68.92±26.16)HU, which were significantly different from the MVT group ( HU, HU, HU, HU and HU, all P<0.05). The attenuation values at 90~140 keV were not significantly different between MVT and NMVT groups. The gradient of CT spectral curve of NMVT group was 1.58±0.89, which was lower than that of MVT group (2.76±0.83, t=-3.48, P=0.002). The CT values on the conventional CT images were not significantly different between MVT and NMVT gruop (t=-1.19, P=0.250). Conclusion CT spectral curve is of some certain value for the differential diagnosis of NMVT and MVT.