能谱CT鉴别诊断孤立性肺结节或肿块的价值

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Abstract Objective: To explore the value of spectral CT in differential diagnosis of lung cancer, inflammatory lesions and tuberculosis. Methods: A total of 78 patients with pulmonary nodules or masses were checked by spectral CT. All patients were divided into lung cancer group(38 cases), pulmonary tuberculosis(20 cases) and inflammatory lesions group(20 cases). The monochromatic CT value, iodine concentration(IC), and slope of spectral attenuation curves, normalized iodine concentration(NIC) and normalized water concentration were measured. The one-way ANOVA and Kruskal-Wallis H test were used to analyze parameters among 3 groups． ROC curves were taken to determine the threshold value of the differential diagnosis. Results: The monochromatic CT value, IC, NIC and slope rate of spectral curve among the three groups had statistically significant differences in both phases(all P<0.05). Pairwise comparison between lung cancer and pulmonary tuberculosis, inflammatory lesions and pulmonary tuberculosis were statistically significant(P<0.05), but there was no statistically significant difference between lung cancer and inflammatory lesions(P>0.05). When NIC(venous phase)>0.325 and NIC>0.298, the sensitivity of diagnosing inflammatory lesions and pulmonary tuberculosis, lung cancer and tuberculosis were respectively 95.0％, 97.4％, and the specificity of them were 85.0％, 75.0％ respectively． Conclusion: The quantitative analysis of multiple parameters using spectral CT imaging has great value in the differentiation of lung cancer and pulmonary tuberculosis, and pneumonia and pulmonary tuberculosis, but it can’t be used to differentiate lung cancer and pneumonia.

Key words： Coin lesion, pulmonary Lung neoplasms Tomography, spiral computed

Received: 24 October 2016

PACS:	Ｒ734.2
	Ｒ814.42

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	Articles by authors
	WANG Li-jie
	MA Ji-wen
	WANG Yong-li
	YU Ying-ying
	WEN Zhi

Cite this article:

WANG Li-jie,MA Ji-wen,WANG Yong-li, et al. Application of spectral CT in differential diagnosis of solitary pulmonary nodules or masses[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(4): 245-249.

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2017/V28/I4/245

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