新双源CT双能虚拟平扫技术在孤立性肺结节诊断中的应用价值

摘要

目的：探讨新双源CT双能虚拟平扫技术在孤立性肺结节诊断中的应用价值。方法选取2013年1月~2014年5月入住我院的49例SPN患者，所有患者均行CT常规平扫与双能增强扫描。经软件处理后得到虚拟平扫图、碘分布图和单能量图。比较真实平扫与虚拟平扫图像的CT值、噪声、信噪比、SPN直径、钙化检出率、增强强化值、碘图CT值、准确度、能谱衰竭曲线图斜率、碘基值比率及辐射剂量。结果真实平扫与虚拟平扫的CT值、图像噪声、图像信噪比及SPN直径差异均无统计学意义（P＞0.05）；增强强化值与碘图CT值差异均具有统计学意义（P＜0.05）；以真实平扫为标准，虚拟平扫图像钙化检出率为93.02%；以虚拟平扫为基线诊断SPN的特异性最高，为92.86%，以碘图CT值诊断SPN的敏感性及准确性最高，分别为77.14%及71.43%；良恶性能谱衰竭曲线图斜率分别为（0.72±0.34）、（1.02±0.59），碘基值比率分别为（0.27±0.11）、（0.22±0.08），二者差异均无统计学意义（P＞0.05）；常规平扫与增强扫描的辐射剂量差异无统计学意义（P＞0.05）。结论新双源CT双能虚拟平扫技术对良恶性SPN的临床诊断具有较高的价值。%Objective To explore the clinical value of new dual-energy CT dual-source virtual scan in the diagnosis of solitary pulmonary nodule (SPN). Methods 49 patients with SPNs treated in our hospital from January 2013 to May 2014 were examined by CT conventional scan and dual-energy enhancement scan. Then the virtual scan images, iodine images and single energy images were obtained through softwares. The CT values, noises, signal to noise ratios, diameters of SPNs, calciifcation detection rates, enhancement values, CT values of iodine images, diagnostic accuracies, slopes of spectrum curves, ratios of iodine-based value and radiation doses were compared between real scan and virtual scan. Results There were no signiifcant differences between the two scan methods on CT value, noise, signal to noise ratio and SPN diameter (P>0.05). There were significant differences between the two scan methods on enhancement value and CT value (P<0.05). The calciifcation detection rate of virtual scan was 93.02%according to real scan. The speciifcity of virtual scan in diagnosing SPNs was 92.86%while the sensitivity and accuracy of CT values of iodine images in diagnosing SPNs were 77.14﹪and 71.43﹪. The slops of spectrum curves of benign SPNs and malignant SPNs were (0.72±0.34) and (1.02±0.59). The iodine base value ratios of benign SPNs and malignant SPNs were (0.27±0.11) and (0.22±0.08). There were no differences between benign SPNs and malignant SPNs on the slop of spectrum curves and iodine base value ratio (P>0.05). There were no signiifcant differences between conventional scan and enhancement scan on radiation dose (P>0.05). Conclusion The new dual-source and dual-energy CT virtual scan is important for the differential diagnosis of benign SPNs and malignant SPNs.