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目的:通过对中心气道原发鳞状细胞癌(SCC)与腺样囊性癌(ACC)的CT能谱扫描及多参数定量测量,探讨CT能谱成像在二者鉴别诊断中的初步应用价值。方法:选取未经任何治疗、行宝石能谱CT检查的中心气道SCC、ACC患者26例,SCC组14例,ACC组12例。符合增强条件者于平扫及动脉期行能谱扫描,将原始数据进行能谱分析,选取肿瘤实性部分作为测量感兴趣区,测量其平扫时40 ke V的CT值、钙含量和水含量;增强扫描动脉期40 ke V的CT值、碘含量、水含量,并计算平扫及动脉期相应能谱曲线斜率。采用独立样本t检验分析平扫及动脉期各参数在各组间有无统计学意义。结果:平扫时,SCC组40 ke V对应CT值、能谱曲线斜率、钙含量均大于ACC组,差异有统计学意义(P<0.05),水含量在两组间的差异无统计学意义(P>0.05)。增强扫描动脉期:SCC组40 ke V下CT值、能谱曲线斜率、碘含量均高于ACC组,差异有统计学意义(P<0.05),水含量间差异无统计学意义(P>0.05)。结论:CT能谱成像可作为中心气道原发SCC与ACC鉴别诊断的一种新方法,具有一定临床应用价值。
OBJECTIVE: To investigate the preliminary application of CT spectral imaging in the differential diagnosis of central squamous cell carcinoma (SCC) and adenoid cystic carcinoma (ACC) by means of CT scanning and multi-parameter quantitative measurement value. Methods: Twenty-six SCC patients with central airway (SCC), 14 patients with SCC and 12 patients with ACC were enrolled in this study. Those who met the enhancement conditions were scanned by energy spectrum during plain scan and arterial period. The original data were analyzed by energy spectrum. The solid part of the tumor was selected as the region of interest. The CT value at 40 keV during plain scan was measured. The calcium content and water Content, CT value, iodine content and water content of 40 ke V during arterial phase scanning were calculated, and the slope of corresponding energy spectrum curve at the time of transthoracic and arterial phase was calculated. The independent sample t-test was used to analyze whether the parameters of the plain and arterial phases were statistically significant among the groups. Results: At the time of plain scan, the CT value of 40 ke V in SCC group was higher than that in ACC group (P <0.05). There was no significant difference in water content between the two groups (P> 0.05). Enhanced scanning arterial phase: CT value at 40 keV in SCC group, slope of energy spectrum curve and iodine content were higher than those in ACC group, the difference was statistically significant (P <0.05), but there was no significant difference between water content (P> 0.05 ). Conclusion: CT spectral imaging can be used as a new method for the differential diagnosis of primary SCC and ACC in central airway, and it has certain clinical value.