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能谱CT在中央型肺癌伴阻塞性肺不张诊断及放疗定位中应用价值

刘秀丽 张戟风 刘景旺 李健 许美 陈静

刘秀丽, 张戟风, 刘景旺, 等. 能谱CT在中央型肺癌伴阻塞性肺不张诊断及放疗定位中应用价值[J]. CT理论与应用研究, 2022, 32(0): 1-6. DOI: 10.15953/j.ctta.2022.164
引用本文: 刘秀丽, 张戟风, 刘景旺, 等. 能谱CT在中央型肺癌伴阻塞性肺不张诊断及放疗定位中应用价值[J]. CT理论与应用研究, 2022, 32(0): 1-6. DOI: 10.15953/j.ctta.2022.164
LIU X L, ZHANG J F, LIU J W, et al. The value of spectral CT in differential diagnosis and radiotherapy localiation of central lung cancer with obstructive atelectasis[J]. CT Theory and Applications, 2022, 32(0): 1-6. DOI: 10.15953/j.ctta.2022.164. (in Chinese)
Citation: LIU X L, ZHANG J F, LIU J W, et al. The value of spectral CT in differential diagnosis and radiotherapy localiation of central lung cancer with obstructive atelectasis[J]. CT Theory and Applications, 2022, 32(0): 1-6. DOI: 10.15953/j.ctta.2022.164. (in Chinese)

能谱CT在中央型肺癌伴阻塞性肺不张诊断及放疗定位中应用价值

doi: 10.15953/j.ctta.2022.164
基金项目: 河北省医学科学研究计划(科技成果推广课题(20221580))。
详细信息
    作者简介:

    刘秀丽:女,沧州医学高等专科学校副教授,主要从事内科及影像专业教学,E-mail:2227593418@qq.com

    刘景旺:男,开滦总医院影像科主任医师,华北理工大学教授、硕士研究生导师,主要从事放射医学诊断工作,E-mail:liujw1585@sina.com

    通讯作者:

    刘景旺*,

The Value of Spectral CT in Differential Diagnosis and Radiotherapy Localiation of Central Lung Cancer with Obstructive Atelectasis

  • 摘要: 目的:探讨能谱CT扫描在诊断中央型肺癌合并阻塞性肺不张及放疗前定位鉴别肿瘤边界、精准勾画靶区中的应用价值。方法:回顾性分析我院65例经病理证实的中央型肺癌伴阻塞性肺不张患者的放疗前定位3期能谱CT扫描的影像资料,比较分析3期增强CT扫描不同参考指标(BMI、BMI-ICM及Eff-Z、PI)显示瘤-肺交界面评分值差异,比较肿瘤与不张肺组织IC值及CT值差异。结果:3期增强CT扫描瘤-肺边界评分4项指标(BMI、BMI-ICM及Eff-Z、PI)间存在统计学差异,BMI-ICM最高,PI最低;动脉期、静脉期及延迟期3期扫描中,显示瘤-肺边界的主观评分有差异,动脉期最高;肿瘤与不张肺组织IC值及CT值差异具有统计学意义,IC值比CT值差别更大。结论:能谱CT扫描的不同指标能帮助鉴别中央型肺癌与不张肺组织的边界,利用最佳指标实现放疗前精准勾画放疗靶区,实现放疗计划最优化。

     

  • 图  1  左肺上叶中央型肺癌并左肺上叶不张混合能量平扫+增强扫描

    Figure  1.  The left upper lobe central lung cancer with obsrtuctive atelectasis of polychromatic image flat scan and enhancement

    图  2  左肺上叶中央型肺癌并左肺上叶不张单能量增强扫描及能谱曲线

    Figure  2.  The Spectral HU curve of the same patient and monochromatic image of 56 keV and 75 keV

    图  3  左肺上叶中央型肺癌并左肺上叶不张最佳单能量56 keV增强扫描碘基图及有效原子序数图

    Figure  3.  The best monochromaticimage combined with iodine concentration map and effective atomic number image

    表  1  增强CT扫描各期PI、BMI及BMI-ICM瘤-肺边界主观评分的比较

    Table  1.   The scores and detection rates of tumor-lung interface of PI, BMI, BMI-ICM and Eff-Z in three phase contrast enchancement

    扫描期相瘤-肺边界主观评分值统计检验
    PIBMIBMI-ICMEff-ZFP
    动脉期2.51±0.833.14±0.853.84±0.313.04±0.55 34.28<0.01
    静脉期2.14±0.652.95±0.893.34±0.252.84±0.2626.54<0.01
    延迟期2.12±0.552.54±0.353.04±0.852.74±0.1518.32<0.01
    下载: 导出CSV

    表  2  增强CT扫描各期肿瘤与不张肺组织碘浓度IC值及CT值的比较

    Table  2.   The scores of tumor-lung interface of IC and CT scores in three phase contrast enchancement

    扫描期相组织IC/100 μg·mL-1CT值/HU统计检验
    肿瘤不张肺组织肿瘤不张肺组织tP
    动脉期12.51±3.8923.71±8.1235.41±6.8550.21±9.76-4.89<0.01
    静脉期11.41±3.2318.31±6.3738.38±4.0342.37±7.83-6.43<0.01
    延迟期10.11±3.6317.96±5.9318.51±5.8417.01±7.73-6.82<0.01
    下载: 导出CSV
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出版历程
  • 收稿日期:  2022-08-13
  • 修回日期:  2022-10-02
  • 录用日期:  2022-10-03
  • 网络出版日期:  2022-10-21

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