能谱CT鉴别肺部炎性肿块与肺癌的临床价值

目的探究能谱CT在鉴别肺部肿瘤以及炎性肿块上临床价值。方法对我院2018年2月~2019年2月收治采用能谱CT进行影像学检查98例肺部出现肿块(113个肿块)患者资料予以回顾性分析,依据患者疾病类型分为肺部炎性肿块组(n=57,69个肿块)与肺癌组(n=42,44个肿块)。比较两组患者扫描期间动脉期以及静脉期不同keV情况下CT值,参数值,两组患者能谱曲线,动静脉各参数值ROC曲线分析。结果肺部炎性组患者动脉期与静脉期不同keV(40-120keV)情况下CT值均显著低于肺癌组(P<0.05);肺部炎性肿块组患者动静脉期NICcen、能谱曲线斜率显著高于肺癌组患者(P<0.05),动静脉期dNIC显著低于肺癌组患者(P<0.05),两组患者动静脉期NICper与水浓度比较差异没有统计学意义(P>0.05);肺炎性肿块患者能谱曲线呈快速下降型,肺癌患者能谱曲线呈缓慢下降型,同时可见肺癌患者散点集中情况更为明显。结论肺部炎性肿块与肺癌可以通过能谱CT检查中NIC、能谱曲线斜率以及曲线变化类型等参数予以鉴别,具有较好临床鉴别价值。

Clinical Value of Energy Spectrum CT in Differential Diagnosis of Pulmonary Inflammatory Lump and Lung Cancer

Objective To investigate the clinical value of energy spectrum CT in differential diagnosis of lung tumors and inflammatory lumps. Methods The data of 98 patients with lung lumps(113 lumps) examined by energy spectrum CT in the hospital from February 2018 to February 2019 were retrospectively analyzed. According to the type of disease, the patients were divided into the pulmonary inflammatory lump group(n=57, 69 lumps) and the lung cancer group(n=42, 44 lumps). CT values, parameters and energy spectrum curves under different keV in arterial phase and venous phase were compared between the two groups. ROC curves were used to analyze arteriovenous parameters. Results The CT values under different keV(40-120 keV) in arterial phase and venous phase of the pulmonary inflammatory lump group were significantly lower than those of the lung cancer group(P<0.05). The NICcen in arterial phase and venous phase and the slop of energy spectrum curves of the pulmonary inflammatory lump group were significantly higher than those of the lung cancer group(P<0.05), while dNIC in arterial phase and venous phase was significantly lower than that of the lung cancer group(P<0.05). There was no significant difference in NICper or water concentration between the two groups in arterial phase or venous phase(P>0.05). The spectrum of patients with pulmonary inflammatory lumps showed a rapid decline while that of patients with lung cancer showed a slow decline. Meanwhile, the concentration of splashes was more obvious in patients with lung cancer. Conclusion Pulmonary inflammatory lump and lung cancer can be identified by parameters such as NIC, slope of energy spectrum curve and the change type of curve in energy spectrum CT, which is of clinical value.