周围型肺腺癌和周围型肺鳞癌的能谱CT表现

目的:观察周围型肺腺癌和周围型肺鳞癌的能谱CT表现。方法:回顾性分析经病理证实并行能谱CT扫描的周围 型肺腺癌122 例和周围型肺鳞癌89 例。测量病灶在动脉期及静脉期下的CT40 keV值、CT70 keV值、CT100 keV值、碘（水）浓度 （IC）、水（碘）浓度（WC）和有效原子序数（Zeff），并计算能谱曲线斜率（K70 keV）。比较两组之间各能谱参数之间的差异。结 果:两组之间性别差异有统计学意义（P<0.05），而其他临床特征和临床症状在两组之间差异无统计学意义（P>0.05）。动 脉期和静脉期，周围型肺腺癌的CT40 keV、CT70 keV、K70 keV、IC及Zeff均大于周围型肺鳞癌，差异具有统计学意义（P<0.05）；而 两组之间的WC和CT100 keV无统计学意义（P>0.05）。ROC曲线分析显示，动脉期各定量参数联合较静脉期各定量参数联 合的诊断效能好，曲线下面积、敏感性和特异性分别为86%、77%、83%。结论:周围型腺癌和周围型鳞癌的能谱CT表现 存在一定差异，可为二者的鉴别提供参考。

Spectral CT findings of peripheral lung adenocarcinoma and peripheral lung squamous cell carcinoma

Objective To compare the spectral computed tomography (CT) findings of peripheral lung adenocarcinoma versus peripheral lung squamous cell carcinoma. Methods A total of 122 cases of peripheral lung adenocarcinoma and 89 cases of peripheral lung squamous cell carcinoma were analyzed retrospectively.All of these cases were proved by pathology and received energy spectral CT examination. The CT40 keV, CT70 keV, CT100 keV, iodine (water) concentration (IC), water (iodine) concentration (WC) and effective atomic number (Zeff) were measured in the arterial phase and the venous phase, and the slope of spectral curve (K70 keV) was calculated. The differences of spectral parameters between two groups were compared. Results There was no significant difference between two groups in clinical features and symptoms (P>0.05) except gender (P<0.05). In the arterial phase and the venous phase, the CT40 keV, CT70 keV, K70 keV, IC and Zeff of peripheral lung adenocarcinoma were higher than those of peripheral lung squamous cell carcinoma, with statistical differences (P<0.05), but no significant difference was found inWC and CT100 keV between two groups (P>0.05). Receiver operating characteristic curve analysis showed that the combination of quantitative parameters in the arterial phase had better diagnostic efficiency than the combination of quantitative parameters in the venous phase, and that the area under the curve, sensitivity and specificity of the former were 86%, 77%, and 83%, respectively. Conclusion There are some differences in spectral CT findings between peripheral lung adenocarcinoma and peripheral lung squamous cell carcinoma, which can provide reference for the differential diagnosis.