CAJ | 학술논문

_目的：探讨能谱 CT 诊断肺结节、肿块的价值。方法：选取33例 X 线发现肺结节、肿块的患者，进行宝石能谱成像（GSI）模式三期增强扫描，利用 GSI 后处理功能，分别测量动脉期（30 s）、静脉期（60 s）及延迟期（90 s）病灶的能谱曲线斜率以及标准化碘浓度（NIC），测定各病灶区混合能量 CT 值，比较各参数间的差异并进行统计学分析。结果：33例患者经手术病理证实，其中恶性病变17例（恶性组），炎性病变8例（炎性组），除炎性病变外的良性病变8例（良性组）。动脉期、静脉期及延迟期三组病变混合能量 CT 值、能谱曲线斜率（40～80 keV）以及 NIC 值均为炎性病变最高，良性病变最低。良性组与其他两组进行比较，病灶在动脉早期及延迟期扫描中混合能量下的 CT 值、能谱曲线斜率及 NIC 值差异均有统计学意义（P＜0．05）；炎性组与恶性组比较，仅能谱曲线斜率及 NIC 值在动脉早期及延迟期差异有统计学意义（P＜0．05）。结论：能谱 CT 有助于鉴别诊断肺结节、肿块，尤其是动脉早期及延迟期的能谱曲线斜率及 NIC 值诊断价值较高。
_목적：탐토능보 CT 진단폐결절、종괴적개치。방법：선취33례 X 선발현폐결절、종괴적환자，진행보석능보성상（GSI）모식삼기증강소묘，이용 GSI 후처리공능，분별측량동맥기（30 s）、정맥기（60 s）급연지기（90 s）병조적능보곡선사솔이급표준화전농도（NIC），측정각병조구혼합능량 CT 치，비교각삼수간적차이병진행통계학분석。결과：33례환자경수술병리증실，기중악성병변17례（악성조），염성병변8례（염성조），제염성병변외적량성병변8례（량성조）。동맥기、정맥기급연지기삼조병변혼합능량 CT 치、능보곡선사솔（40～80 keV）이급 NIC 치균위염성병변최고，량성병변최저。량성조여기타량조진행비교，병조재동맥조기급연지기소묘중혼합능량하적 CT 치、능보곡선사솔급 NIC 치차이균유통계학의의（P＜0．05）；염성조여악성조비교，부능보곡선사솔급 NIC 치재동맥조기급연지기차이유통계학의의（P＜0．05）。결론：능보 CT 유조우감별진단폐결절、종괴，우기시동맥조기급연지기적능보곡선사솔급 NIC 치진단개치교고。
To study the value of spectral CT imaging in differentiation of pulmonary nodules/masses. Methods:33 cases with pulmonary nodule or mass received triphasic pulmonary enhanced CT scan in GSI (gemstone spectral imaging)mode on a MDCT (Discovery CT 750 HD,GE healthcare).All raw data were sent to AW4.6 workstation and processed by the software of GSI work station.CT value under mixture energy,slope rate of spectral curve,normalized io-dine concentration (NIC)were measured and calculated in three phases,respectively.Variances among parameters were ana-lyzed and T-Test was used to compare the results.Results:33 cases proved by pathology were divided into three groups. Group A:inflammatory lesions (8 cases),group B:benign lesions except inflammatory cases (8 cases)and group C:malig-nant lesions (17 cases).These three parameters,CT value under mixture energy,slope rate of spectral curve,and normalized iodine concentration,were found highest in group A,and lowest in group B.There were significant differences in the three parameters either between group B and C or between group B and A in arterial phase and delayed phase.In arterial phase and delayed phase,there were significant differences in the slope rate and NIC between group A and C.Conclusion:Spectral CT imaging is helpful in the diagnosis of pulmonary nodules/masses,especially the slope rate of spectral curve and NIC val-ue in both arterial and delayed phases.