CAJ | 학술논문

目的：初步探讨 CT 能谱成像在鉴别结核性胸腔积液与恶性胸腔积液中的应用价值。方法回顾性分析在本院行能谱CT 扫描的经病理学确诊的胸腔积液患者67例(结核性31例,恶性36例)。应用能谱分析软件,获得2组胸腔积液各感兴趣区能谱衰减曲线图、碘(水)基图,分析其不同 keV 水平下 CT 值、有效原子序数及碘-水浓度等能谱成像定量参数的差异,根据公式：斜率=(HU40-HU90)/50计算各感兴趣区能谱曲线斜率。对2组积液的能谱特征参数进行独立样本 t 检验。结果结核性胸腔积液能谱曲线斜率(0.23±0.08)明显小于恶性胸腔积液能谱曲线斜率(0.45±0.22),存在统计学差异(t =5.23,P =0.00<0.05)。结核性与恶性胸腔积液有效原子序数分别为7.67±0.11和7.78±0.04,差别有统计学意义(t=5.45,P <0.05)。结核性与恶性胸腔积液碘(水)含量比分别为(0.19±0.07)g/L 和(0.37±0.18)g/L,差别有统计学意义(P <0.05),但两者水(碘)浓度分别为(1068.27±0.01)g/L 和(1067.48±0.01)g/L,差别无统计学意义(t=0.53,P =0.60>0.05)。结论2组胸腔积液具有不同的能谱曲线和能谱特征物质含量,CT 能谱成像为两者的鉴别诊断提供了一种可供参考的多参数影像学检查方法。
목적：초보탐토 CT 능보성상재감별결핵성흉강적액여악성흉강적액중적응용개치。방법회고성분석재본원행능보CT 소묘적경병이학학진적흉강적액환자67례(결핵성31례,악성36례)。응용능보분석연건,획득2조흉강적액각감흥취구능보쇠감곡선도、전(수)기도,분석기불동 keV 수평하 CT 치、유효원자서수급전-수농도등능보성상정량삼수적차이,근거공식：사솔=(HU40-HU90)/50계산각감흥취구능보곡선사솔。대2조적액적능보특정삼수진행독립양본 t 검험。결과결핵성흉강적액능보곡선사솔(0.23±0.08)명현소우악성흉강적액능보곡선사솔(0.45±0.22),존재통계학차이(t =5.23,P =0.00<0.05)。결핵성여악성흉강적액유효원자서수분별위7.67±0.11화7.78±0.04,차별유통계학의의(t=5.45,P <0.05)。결핵성여악성흉강적액전(수)함량비분별위(0.19±0.07)g/L 화(0.37±0.18)g/L,차별유통계학의의(P <0.05),단량자수(전)농도분별위(1068.27±0.01)g/L 화(1067.48±0.01)g/L,차별무통계학의의(t=0.53,P =0.60>0.05)。결론2조흉강적액구유불동적능보곡선화능보특정물질함량,CT 능보성상위량자적감별진단제공료일충가공삼고적다삼수영상학검사방법。
Objective To evaluate the diagnostic value of dual energy spectral CT imaging in differentiating tuberculous from ma-lignant pleural effusions.Methods 67 hydrothorax patients (31 with tuberculous pleural effusions and 36 with malignant pleural ef-fusions,confirmed pathologically)were retrospectively analyzed.They underwent plain CT with spectral imaging mode.Spectral CT parameters for the hydrothorax were obtained:effective-Z and iodine and water concentrations from the material decomposition ima-ges.Spectral HU curve (CT value as function of photon energy)was generated from the set of monochromatic images,and the slope k of the curve was further calculated as k=[HU(40 keV)-HU(90 keV)]/50.Results of the two groups were analyzed with inde-pendent sample t test.Results The slope of the spectral HU curve for malignant pleural effusions (0.45 ±0.22 )was statistically higher than that for tuberculous pleural effusions (0.23±0.08),(t=5.23,P <0.05).The effective-Z values for tuberculous and malignant pleural effusions were (7.67±0.1 1 )and (7.78±0.04),respectively,with significant difference between them (t=5.45, P <0.05).The iodine concentrations were (0.1 9±0.07)g/L and (0.37 ±0.18)g/L in the tuberculous pleural effusions and malig-nant pleural effusions,respectively,with significant difference (P <0.05).While there was no difference for the water concentra-tions between the tuberculous pleural effusions (1 068.27±0.01)g/L and malignant pleural effusions (1 067.48±0.01)g/L,(P =0.60>0.05).Conclusion Spectral CT provided additional parameters than conventional CT for effectively differentiating tuberculous pleural effusions from malignant pleural effusions.Spectral CT may be used to better differentiate tuberculous pleural effusions from malignant pleural effusions .