目的：评估双能CT碘图对孤立性肺结节（Solitary pulmonary nodule，SPN）良恶性鉴别诊断的价值。方法：对经病理证实的68例SPN患者行双能CT平扫和增强扫描。双能CT增强扫描图像经双能软件处理后，生成碘图。对SPN进行动脉期、静脉期病灶强化值和碘图CT值测量以及标准化碘基值测量分析，并以病理结果为对照评价其鉴别诊断价值。结果：68例SPN，48例为恶性，其中腺癌36例、鳞癌5例、小细胞癌7例；20例为良性，其中炎症7例、结核10例、腺瘤2例、错构瘤1例。良恶性组比较，动脉期、静脉期恶性组CT增强强化值（△CT）、碘图CT值（Overlay）及标准化碘基值（NIV）均高于良性组，有统计学意义（P<0.05）。良恶性组动脉期、静脉期△CT均小于Overlay值，静脉期恶性组有统计学意义（P<0.05）。结论：双能CT碘图分析有助于SPN良恶性的鉴别诊断。
Abstract
Objective: To evaluate the value of iodine mapping of dual-energy CT(DECT) in differential diagnosis of solitary pulmonary nodule(SPN). Methods: Sixty-eight patients with SPNs proved by pathology underwent DECT scans. The iodine images were derived from the arterial phase(AP) and venous phase(VP) using software of dual-energy processing. CT numbers of SPN on enhanced weighted images and iodine-enhanced images and iodine value were measured, and their diagnostic value was evaluated basing on pathological results. Results: In 68 proved cases of SPN, 48 cases were malignant, including adenocarcinoma(n=36), squamous carcinoma(n=5) and small cell carcinoma(n=7), and 20 cases were benign, including inflammation(n=7), tuberculosis(n=10), adenoma(n=2) and hamartoma(n=1). There were significantly higher degree of enhancement(△CT), CT number on the iodine-enhanced images(Overlay) and the standardization of iodine value(NIV) in malignant group than benign group in both AP and VP(P<0.05). The △CT value was less than the overlay in both AP and VP and was statistically significant difference in malignant group in VP(P<0.05). Conclusion: The iodine mapping of DECT is helpful for differential diagnosis of SPN.
关键词
硬币病变 /
肺；体层摄影术 /
X线计算机
Key words
Coin lesion, pulmonary /
Tomography, X-ray computed
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基金
浙江省卫生厅科技计划项目资助（2011KYB025）。
