|本期目录/Table of Contents|

[1]王雪梅,石 华,杨露露,等.能谱CT定量分析在鉴别诊断肺鳞癌与腺癌中的应用价值[J].宁夏医科大学学报,2013,(04):415-418.
 WANG Xue-mei,SHI Hua,YANG Lu-lu,et al.Value of Spectral CT Imaging in Differentiating Plumonary Squamous Cell Carcinoma and Adenocarcinoma[J].Ningxia Medical University,2013,(04):415-418.
点击复制

能谱CT定量分析在鉴别诊断肺鳞癌与腺癌中的应用价值(PDF)
分享到:

《宁夏医科大学学报》[ISSN:1005-8486/CN:64-1029/R]

卷:
期数:
2013年04期
页码:
415-418
栏目:
论著
出版日期:
2013-04-20

文章信息/Info

Title:
Value of Spectral CT Imaging in Differentiating Plumonary Squamous Cell Carcinoma and Adenocarcinoma
作者:
王雪梅1 石 华1 杨露露1 张小羽2 刘 云2
1.宁夏医科大学,银川 750004; 2.宁夏医科大学总医院心脑血管病医院放射科,银川 750004
Author(s):
WANG Xue-mei SHI Hua YANG Lu-lu ZHANG Xiao-yu LIU Yun
Ningxia Medical University, Yinchuan 750004
关键词:
目的 探讨能谱CT在肺鳞癌与腺癌鉴别诊断中的应用价值。方法 选择2011年8月至2012年6月在我院行能谱CT扫描并经病理证实的肺癌患者46例(鳞癌28例腺癌18例)对比分析两组病例平扫及增强扫描后的能谱特征参数及能谱曲线。结果 平扫鳞癌的有效原子序数及钙含量均大于腺癌分别为(7.82±0.08)和(7.73±0.07)、(4.69±1.27)和(3.01±1.53)mg·mL-1差异有统计学意义(P均<0.05)。
Keywords:
lung cancer tomographyX-ray computed spectral CT imaging spectral HU curve
分类号:
R734.2
DOI:
-
文献标志码:
A
摘要:
目的 探讨能谱CT在肺鳞癌与腺癌鉴别诊断中的应用价值。方法 选择2011年8月至2012年6月在我院行能谱CT扫描并经病理证实的肺癌患者46例(鳞癌28例,腺癌18例),对比分析两组病例平扫及增强扫描后的能谱特征参数及能谱曲线。结果 平扫鳞癌的有效原子序数及钙含量均大于腺癌,分别为(7.82±0.08)和(7.73±0.07)、(4.69±1.27)和(3.01±1.53)mg·mL-1,差异有统计学意义(P均<0.05)。增强扫描70keV单能量下鳞癌和腺癌的强化程度差异无统计学意义(t=1.26,P=0.21); 鳞癌能谱曲线斜率及标准碘含量(1.90±0.22、0.14±0.02)大于腺癌(1.55±0.13、0.12±0.01),P均<0.05。ROC曲线分析显示曲线斜率鉴别鳞癌和腺癌具有较高的灵敏度(86%)和特异度(89%),且曲线下面积0.93。结论 肺鳞癌和腺癌具有不同的能谱曲线和能谱特征参数,能谱CT可为鳞癌和腺癌的鉴别诊断提供一种新的多参数的方法。
Abstract:
Objective To investigate the feasibility of differentiating plumonary squamous cell carcinoma and adenocarcinoma by using dual energy spectral CT imaging. Methods 46 lung cancer patients(28 patients with squamous cell carcinoma and 18 patients with adenocarcinoma)underwent plain and enhanced CT scans with spectral imaging mode. Spectral CT imaging related parameters for the cancers such as calcium concentration and effective-Z in the plain CT and normalized iodine concentration(NIC, to that of aorta)and spectral HU curve in the enhanced CT were obtained. The increment of CT value in 70 keV was calculated as ΔCT=CTenhanced-CTplain.The slope k of spectral HU curve was calculated as k=[HU(40keV)-HU(90keV)]/50. All results were compared with independent samples t test. Receiver operating characteristic(ROC)curves were generated to determine parameters for optimizing sensitivity and specificity in differentiating two different lung cancers. Results ① In plain CT: The effective-Z(7.82±0.08)and calcium concentration(4.69±1.27mg·mL-1)of squamous cell carcinoma were significantly higher than those of adenocarcinoma [(7.73±0.07),(3.01±1.53mg·mL-1)](t=4.06,3.70,P<0.05). ②In enhanced CT: There was no difference in increment of CT value in 70 keV between squamous cell carcinoma and adenocarcinoma(t=1.26, P=0.21). The slope k and NIC were(1.90±0.22, 0.14±0.02)and(1.55±0.13,0.12±0.01)for squamous cell carcinoma and adenocarcinoma,respectively, the differences in the slope k and NIC between two pathological types of lung cancers showed all significant(t=6.81, 2.81, P=6.81, 2.81, ;0.05). ③The slope in the enhanced CT provided high sensitivity and specificity in differentiating squamous cell carcinoma and adenocarcinoma(86% and 89%, respectively),and the area under the ROC curve was 0.93. Conclusion Spectral CT imaging provided additional parameters than conventional CT for plumonary squamous cell carcinoma and adenocarcinoma that were statistically different, and it may become an effective diagnostic method to improve the sensitivity and specificity in differentiating these two pathological types of lung cancers.

参考文献/References:

[1] Ferlay J,Shin HR,Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008[J].International Journal of Cancer, 2010,127(12):2893-2917.
[2] Jemal A,Bray F, Melissa M,et al.Global cancer statistics[J].CA Cancer J Clin,2011,61(2):69-90.
[3] 彭丽静,胡效坤,刘道义,等.肺癌病理组织类型与影像学征象及临床表现的相关性研究[J].医学影像学杂志, 2007,17(8):826-829.
[4] Travis WD, Brambilla E, Noguchi M, et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma[J]. J Thorac Oncol, 2011,6(2):244-285.
[5] 林晓珠,李卫侠,朱延波,等.能谱CT在肿瘤诊断中的初步应用[J].诊断学理论与实践,2010,9(2):155-160.
[6] 李剑颖.CT能量成像技术进展和临床应用[J].CT影像杂志,2010,11(3):10-13.
[7] 张文,于长海,李英杰,等.CT值与肿瘤分化程度、病理类型及淋巴结转移相关性的临床研究[J].临床肺科杂志,2011,16(10):1554-1555.
[8] 蒋勇,徐敏光,仇保跃.宝石HDCT的技术特点与临床应用展望[J].医疗卫生设备,2010,31(1):98-99.
[9] 迟永堃,孙应实,张晓鹏.利用能谱CT单能CT值区别霍奇金病与非霍奇金淋巴瘤的初步研究[J].中华放射学杂志:能谱征文论文集,2011:116-119.
[10] 林晓珠,陈克敏,吴志远,等.CT能谱成像在鉴别胰腺寡囊型浆液性囊腺瘤与黏液性囊性肿瘤中的价值[J].中华放射学杂志,2011,45(8):713-717.
[11] 许骅,李剑颖.有效原子序数的原理与临床应用初探[J].CT影像杂志,2011,13(2):60-63.
[12] 任振峰.肺癌钙化的CT诊断[J].中华现代影像学杂志,2009,6(6):328.
[13] Mahoney MC, Shipley RT, Corcoran SS, et al. CT demonstration of calcification in carcinoma of the lung[J].AJR, 1990,154(2): 255.
[14] 张正福,王海燕,李伟,等.肺癌钙化的CT表现及意义探讨[J].中国肿瘤临床与康复,2007,14(3):249-250.
[15] Linden A. Measuring diagnostic and predictive accuracy in disease management: an introduction to receiver operating characteristic(ROC)analysis[J]. J Eval Clin Pract, 2006,12(2): 132-139.

相似文献/References:

[1]孔繁智,高兵,田永福,等.冠心病患者血清同型半胱氨酸水平及影响因素分析[J].宁夏医科大学学报,2016,(07):768.[doi:10.16050/j.cnki.issn1674-6309.2016.07.010]
 KONG Fanzhi,GAO Bing,TIAN Yongfu,et al.Analysis of the Serum Homocysteine Levels and Influential Factors in Patients with Coronary Heart Disease[J].Ningxia Medical University,2016,(04):768.[doi:10.16050/j.cnki.issn1674-6309.2016.07.010]

备注/Memo

备注/Memo:
收稿日期:2012-09-12 作者简介:王雪梅(1986-),女,山东人,在读硕士研究生,从事医学影像学与核医学专业。 通信作者:刘云,主任医师,主要研究胸部影像学。E-mail:yunliushky@hotmail.com
更新日期/Last Update: 2013-04-20