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目的探讨双源光子CT双能量扫描在肺良恶性肿瘤鉴别中的价值。方法回顾性分析经病理证实的41例肺肿瘤患者(良性11例,恶性30例)的双能CT图像。所有患者均行双能量CT平扫及双期增强扫描。通过测量得出肿块的动脉期CT强化值(CT_(AP))、静脉期CT强化值(CT_(VP))及动静脉期CT净增值(CTAV)、动脉期及静脉期碘分布图CT值(CT_(IAP)、CT_(IVP))及净增值(CT_(IAV)),使用独立样本t检验比较良恶性肿瘤之间的差异,并绘制受试者工作特征曲线(ROC)评价其诊断效能。结果良、恶性肿瘤之间CT_(AP)、CT_(VP)、CT_(IAP)和CT_(IVP)差异均无统计学意义(P>0.05),而CTAV和CT_(IAV)有统计学意义(t=2.70,P<0.05;t=3.38,P<0.05);CT_(AV)诊断良恶性肿块的敏感度、特异度分别为63.6%、83.3%;CT_(IAV)分别为72.7%、90.0%。结论相对肺内肿瘤强化值,碘图CT值更有助于良恶性的鉴别。
Objective To investigate the value of dual-source photon double-energy scanning in differential diagnosis of benign and malignant lung tumors. Methods The bi-functional CT images of 41 patients with lung cancer (benign and 11 malignant and 30 benign) confirmed by pathology were retrospectively analyzed. All patients underwent dual-energy CT plain scan and double-phase enhanced scan. The CT value (CT_ (AP)), CT enhancement (CT_ (VP)) and net CT value of arterial and venous phases (CTAV) and arterial phase and venous phase iodine distribution CT value (IAP), CT IVP and CT IAV were compared with each other. The differences between benign and malignant tumors were compared using the independent sample t-test and the receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy . Results There were no significant differences in CT AP, CT VP, CT IAP and CT IVP between benign and malignant tumors (P> 0.05), but there were significant differences between CTAV and CT IAV t = 2.70, P <0.05; t = 3.38, P <0.05). The sensitivity and specificity of CT (AV) in diagnosing benign and malignant tumors were 63.6% and 83.3% . Conclusion Compared with the enhanced value of intrapulmonary tumors, the CT value of iodine is more helpful in differentiating benign and malignant tumors.