肺磨玻璃结节能谱CT参数变化及其临床价值研究-东南大学学报医学版

肺磨玻璃结节能谱CT参数变化及其临床价值研究

单位：江阴市中医院影像科, 江苏江阴 214400

分类号：R734.2; R814.42

出版年·卷·期（页码）：2023·42·第三期（419-425）

摘要：

目的: 探讨肺磨玻璃结节(GGNs)能谱CT参数变化及其临床价值。方法: 选取我院92例经手术病理证实的肺GGNs患者,根据病理学类型分为良性组(n=50)和恶性组(n=42)。比较两组能谱CT参数,分析能谱CT参数诊断肺GGNs良恶性的效能、与恶性肺GGNs临床分期的相关性,恶性组均随访2年,比较高危与低危患者生存率。结果: 良性组平扫期和动脉期水含量、动脉期能谱曲线斜率(k值)均低于恶性组,平扫期k值高于恶性组(P＜0.05);平扫期和动脉期水含量、k值诊断肺GGNs为恶性的曲线下面积(AUC)分别为0.832、0.838、0.922、0.701,均具有一定诊断价值;恶性组临床分期Ⅰ~Ⅱ期患者平扫期和动脉期水含量、动脉期k值均低于Ⅲ~Ⅳ期患者,平扫期k值高于Ⅲ~Ⅳ期患者(P＜0.05);恶性肺GGNs临床分期与平扫期和动脉期水含量、动脉期k值呈正相关,与平扫期k值呈负相关(P＜0.05);平扫期和动脉期水含量、k值高危患者存活率低于低危患者(P＜0.05)。结论: 能谱CT参数在肺GGNs良恶性诊断方面具有良好诊断效能,且各参数与恶性肺GGNs临床分期及预后密切相关。

Objective: To investigate the changes of energy spectrum CT parameters of ground glass nodules(GGNs) and its clinical value. Methods: Ninety-two patients with lung GGNs confirmed by surgery and pathology were selected from our hospital and divided into benign group(n=50) and malignant group(n=42) according to pathological type. Energy spectrum CT parameters of the two groups were compared to analyze the efficacy of energy spectrum CT parameters in diagnosing benign and malignant lung GGNs and the correlation with the clinical stage of malignant lung GGNs. The malignant group was followed up for 2 years to compare the survival rates of high-risk and low-risk patients. Results: The water content in the flat and arterial phases and the slope of the energy spectrum(k-value) in the arterial phase were lower in the benign group than those in the malignant group, and the k-value in the flat phase was higher than that in the malignant group(P<0.05); The area under the curve(AUC) for diagnosing pulmonary GGNs as malignant was 0.832, 0.838, 0.922 and 0.701 for water content and k value in the plain and arterial phases, respectively, all of which had some diagnostic value; the water content in the plain and arterial phases, and the k value in the arterial phase in the malignant group patients with clinical stages Ⅰ-Ⅱ were lower than those in patients with stages Ⅲ-Ⅳ. The k value in the plain phase was higher than that in patients with stage Ⅲ-Ⅳ(P<0.05); Clinical stage of malignant pulmonary GGNs was positively correlated with plain and arterial water content and arterial phase k-values and negatively correlated with plain phase k-values(P<0.05); survival rate was lower in patients at high risk for plain and arterial water content and k-values than that at low risk(P<0.05). Conclusion: Energy-spectrum CT parameters have good diagnostic efficacy in the diagnosis of benign and malignant pulmonary GGNs, and each parameter is closely related to the clinical stage and prognosis of malignant pulmonary GGNs.

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