| 景俊峰,迟 达,张 昕,韦宇明,张博文.双能量增强CT扫描对非小细胞肺癌纵隔淋巴结转移的诊断价值分析[J].,2020,(5):961-965 |
| 双能量增强CT扫描对非小细胞肺癌纵隔淋巴结转移的诊断价值分析 |
| Dual-energy Enhanced CT Scan in the Diagnosis of Mediastinal Lymph Node Metastasis of Non-small Cell Lung Cancer |
| 投稿时间：2019-11-07 修订日期：2019-11-30 |
| DOI：10.13241/j.cnki.pmb.2020.05.036 |
| 中文关键词: 双能量增强CT 非小细胞肺癌 纵隔淋巴结转移 能谱曲线 能谱曲线斜率 标准化碘浓度 |
| 英文关键词: Dual-energy enhanced CT Non-small cell lung cancer Mediastinal lymph node metastasis Energy spectrum curve Energy spectrum curve Normalization iodine concentration |
| 基金项目:辽宁省科学技术计划项目（20170530869） |
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| 中文摘要: |
| 摘要 目的：探讨双能量增强CT扫描诊断非小细胞肺癌（NSCLC）纵隔淋巴结转移的应用价值。方法：回顾性分析我院2017年5月至2019年5月接诊的100例行肺部双能量增强CT扫描的NSCLC患者临床资料，根据术后病理诊断是否发生纵膈淋巴结转移将患者转移组（42例）和未转移组（58例）。比较组间能谱曲线斜率（λHU）、淋巴结与原发癌灶能谱曲线斜率比值（简称斜率比值）、碘浓度（IC）、水浓度（WC）、标准化碘浓度（NIC）、标准化水浓度（NWC）差异，Logistic回归分析双能CT参数与NSCLC发生纵膈淋巴结转移的相关性，受试者工作特征曲线（ROC）分析双能CT参数诊断NSCLC发生纵膈淋巴结转移的效能。结果：转移组λHU、斜率比值、IC、NIC均低于未转移组（P＜0.05），转移组λHU、IC、WC、NIC、NWC与原发病灶比较均无统计学差异（P＞0.05），未转移组λHU、IC、NIC高于原发病灶（P＜0.05）。Logistic回归分析结果显示λHU、斜率比值、IC、NIC均与纵膈淋巴结转移有关（P＜0.05）。ROC分析结果显示λHU、斜率比值、IC、NIC诊断NSCLC纵膈淋巴结转移的AUC分别为0.849、0.871、0.838、0.860，灵敏度分别为80.95%、85.71%、78.57%、83.33%，特异度分别为79.31%、84.48%、81.03%、82.76%。结论：双能量增强CT扫描检查有助于提高NSCLC淋巴结转移准确率。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the value of dual-energy enhanced CT in the diagnosis of mediastinal lymph node metastasis in non-small cell lung cancer (NSCLC). Methods: The clinical data of 100 NSCLC patients who were receiving dual-energy enhanced lung CT scan in our hospital from May 2017 to May 2019 were retrospectively analyzed. Patients were divided into the metastatic group (42 cases) and the non-metastatic group (58 cases) whether mediastinal lymph node metastasis occurs according to postoperative pathological diagnosis. The differences of the slope of the energy spectrum curve (λHU), the ratio of the slope of the energy spectrum curve between lymph nodes and primary cancer foci (slope ratio for short), iodine concentration (IC), water concentration (WC), normalization iodine concentration (NIC), normalization water concentration (NWC) were compared. Logistic regression analysis was performed to analyze the correlation between dual-energy CT parameters and mediastinal lymph node metastasis in NSCLC, and the Receiver operator characteristics curve (ROC) was used to analyze the efficacy of dual-energy CT parameters in diagnosing mediastinal lymph node metastasis in NSCLC. Results: The λHU, slope ratio, IC and NIC in the metastatic group were lower than those in the non-metastatic group (P<0.05). There was no significant difference of λHU, IC, WC, NIC and NWC between the metastatic group and the primary lesion (P>0.05). The λHU, IC and NIC in the non-metastatic group were higher than those in the primary lesion (P<0.05). Logistic regression analysis showed that λHU, slope ratio, IC and NIC were all associated with mediastinal lymph node metastasis (P<0.05). ROC analysis results showed that the AUC of λHU, slope ratio, IC and NIC in diagnosing mediastinal lymph node metastasis of NSCLC were 0.849, 0.871, 0.838, 0.860, respectively. The sensitivity were 80.95%, 85.71%, 78.57% and 83.33%, respectively, and the specificity was 79.31%, 84.48%, 81.03% and 82.76%, respectively. Conclusion: Dual-energy enhanced CT scan is helpful to improve the accuracy of NSCLC lymph node metastasis. |
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