摘要
目的 探讨能谱CT联合MRI-DWI在鉴别肺炎性结节与肺癌中的价值.方法 选取我院经病理或随访证实的肺炎性结节组与肺癌组患者各 25 例,均行宝石能谱CT成像(GSI)及MRI-DWI.采用统计学分析比较两组各能谱参数、ADC值的差异,ROC曲线分析各指标的诊断效能,P<0.05 为差异有统计学意义.结果 肺炎性结节与肺癌两组的Eff-Z、平扫CT值、动脉期CT值、静脉期CT值、动脉期标准化碘浓度(NIC)、静脉期NIC、静脉期净增IC(dIC)、动脉期净增CT值(dCT)、静脉期dCT的差异均有统计学意义(P<0.05),两组动脉期碘浓度(IC)、静脉期IC、动脉期dIC、动脉期λ40～90 及静脉期λ40～90 的差异均无统计学意义(P>0.05);两组间ADC值的差异有统计学意义(P<0.05);且不同b值情况下肺癌组ADC值均低于肺炎性结节组;随着b值的升高,肺癌组ADC值下降显著.能谱参数中静脉期dCT的诊断价值最高,AUC为 0.848(0.718～0.934),敏感度为 80%,特异度为 92%;DWI扫描中b值 1000 的诊断价值最高,AUC为0.934(0.826～0.985),敏感度为 96%,特异度为 92%.两者联合诊断效能最佳.结论 能谱CT及MRI-DWI在肺炎性结节与肺癌的鉴别诊断中有重要价值,两种检查方法联合能够提高鉴别诊断效能.
Abstract
Objective To investigate the value of energy spectrum CT combined with MRI-DWI in differentiating pulmonary inflammatory nodules from lung cancer.Methods Twenty five patients with pulmonary inflammatory nodules and 25 patients with lung cancer confirmed by pathology or follow-up were collected.All patients were scanned by gemenergy spectrum CT(GSI)and diffusion weighted MRI imaging(DWI).Statistical analysis was used to compare the differences of energy spectrum param-eters and ADC values between the two groups,and ROC curve was employed to analyze the diagnostic efficacy of each index.P＜0.05 was considered statistically significant.Results There were significant differences in Eff-Z,CT value of plain scan,CT value of arterial phase,CT value of venous phase,NIC of arterial phase,NIC of venous phase,dIC of venous phase,dCT of arte-rial phase and dCT of venous phase between the two groups(P<0.05).There were no significant differences in IC of arterial phase,IC of venous phase,dIC of arterial phase,λ40～90 of arterial phase and λ40～90 of venous phase between the two groups(P＞0.05).The difference of ADC values between the two groups was statistically significant(P<0.05).ADC values of lung cancer group were lower than those of pulmonary inflammatory nodules group under different b values.With the increase of b value,ADC value in lung cancer group decreased significantly.The diagnostic value of venous phase dCT was the highest among energy spectrum parameters,with AUC of 0.848(0.718～0.934),sensitivity of 80%,and specificity of 92%.The diagnostic value of b value 1000 in DWI scan was the highest,with AUC of 0.934(0.826～0.985),sensitivity of 96%,and specificity of 92%.The combination of the two methods had the best diagnostic efficacy.Conclusion Energy spectrum CT and MRI-DWI have impor-tant value in the differential diagnosis of pulmonary inflammatory nodules and lung cancer.The combination of the two methods can improve the differential diagnosis efficiency.
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