摘要:
目的:能谱CT平扫 (靶扫描) 在非小细胞肺癌与炎性肿块应用价值.方法:回顾性分析2016年10月-2018年3月107例经病理证实并行能谱CT平扫的肺占位病例, 其中包括腺癌55例、鳞癌29例及炎性肿块 (不含结核) 23例.应用能谱成像 (GSI) 分析软件分别测量3组病例的水 (钙) 浓度、有效原子序数 (Eff-Z) 值及40~140ke V (间隔10ke V) 下的CT值, 并分别计算3组数据平扫能谱曲线斜率K40~90ke V (绝对值) , 进行统计学分析, 分别比较各组参数差异.结果:炎性组平扫能谱曲线斜率K40~90ke V、有效原子序数及水 (钙) 浓度分别为 (1.52±0.13) 、 (6.82±0.19) 和 (1065.79±8.58) mg/cm3;腺癌组K40~90ke V、Eff-Z及水 (钙) 浓度分别为 (0.67±0.18) 、 (7.93±0.13) 和 (1026.04±10.10) mg/cm3;鳞癌组K40~90ke V、Eff-Z及水 (钙) 浓度分别为 (0.40±0.15) 、 (7.38±0.11) 和 (1053.14±8.82) mg/cm3.能谱曲线斜率K40~90ke V炎性组最大, 腺癌次之, 鳞癌最小;有效原子序数腺癌组最大, 鳞癌组次之, 炎性组最小;水 (钙) 浓度炎性组最大, 鳞癌次之, 腺癌组最小, 各组数据差异具有统计学意义 (P <0.05).结论:在能谱平扫中肺腺癌、鳞癌及炎性肿块各组具有不相同的定量参数, 对于肺腺癌、鳞癌及炎性肿块的鉴别诊断有重要的应用价值.%Purpose: To evaluate the application of plain scan with energy spectral CT in non-small cell lung cancer and inflammatory mass. Methods: One hundred and seven cases of lung mass, which were performed the energy spectrum CT from October 2016 to March 2018, were retrospectively analyzed. These cases included 55 adenocarcinomas, 29 squamous cell carcinomas and 23 inflammatory masses without tuberculosis. Energy spectral analysis software (GSI Viewer) was used to measure the water (calcium) concentration, effective atomic number value and CT value at 40-140 keV (10 keV interval) for each of the three groups. After that, the slopes of K40-90 keV (absolute value) of the energy spectrum curve of these three groups of data were calculated. Finally, statistical analysis was performed to compare the differences of parameters among each group. Results: ① The K40-90 ke V, Eff-z and water (calcium) concentration in the inflammatory group were (1.52±0.13) , (6.82±0.19) , (1065.79±8.58) , respectively; ② The K40-90 kev, Eff-z and water (calcium) in the adenocarcinoma group concentration were (0.67±0.18) , (7.93±0.13) , (1026.04±10.10) , respectively; ③ The K40-90 kev, Eff-z and water (calcium) concentrations in the squamous cell carcinoma group were (0.40±0.15) , (7.38±0.11) , (1053.14±8.82) , respectively. Inflammatory masses had the largest standard deviation value of the slope of energy spectral curve, followed by the adenocarcinoma, and the adenocarcinoma had the smallest one. The standard deviation value of the effective atomic number of adenocarcinoma, squamous cell carcinoma and inflammatory masses were in descending order. The standard deviation value of the water (calcium) concentration of adenocarcinoma, squamous cell carcinoma and inflammatory masses were in ascending order. There were statistical significant differences between each group (P<0.05). Conclusion:These three groups have different quantitative parameters in plain scans of energy spectral CT which have important application value.