發(fā)布時(shí)間：2018-03-11 12:17

  本文選題：孤立性肺結(jié)節(jié)　切入點(diǎn)：能譜成像　出處：《大連醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過對孤立性肺結(jié)節(jié)(solitary pulmonary nodule,SPN)的能譜CT掃描中標(biāo)準(zhǔn)化碘濃度、有效原子序數(shù)及40-90ke V的能譜曲線斜率的定量測量,探討能譜CT成像在孤立性肺結(jié)節(jié)定性診斷及病理分型中的應(yīng)用。方法:選取2013年9月至2016年12月因孤立性肺結(jié)節(jié)就診于我院的85例住院患者,其中男性49人,女性36人;年齡30-78歲,平均年齡46.7歲。所有入組患者均接受寶石能譜CT以能譜掃描模式(GSI)進(jìn)行胸部雙期增強(qiáng)掃描;所有診斷均經(jīng)過手術(shù)病理或活檢穿刺證實(shí)。包括:非結(jié)核性炎癥17例、肺結(jié)核25例、惡性結(jié)節(jié)43例,其中包括腺癌(19例)、鱗癌(24例)。獲得孤立性肺結(jié)節(jié)動脈期的標(biāo)準(zhǔn)化碘濃度、有效原子序數(shù)及40-90ke V能譜曲線斜率。所有數(shù)據(jù)應(yīng)用SPSS統(tǒng)計(jì)分析軟件(17.0版本)分析,定量資料采用均數(shù)±標(biāo)準(zhǔn)差表示,對非結(jié)核性炎癥、肺結(jié)核、惡性肺結(jié)節(jié)與肺腺癌、肺鱗癌的動脈期標(biāo)準(zhǔn)化碘濃度、有效原子序數(shù)及40-90ke V能譜曲線斜率分別進(jìn)行t檢驗(yàn),P0.05表示有統(tǒng)計(jì)學(xué)差異。結(jié)果:非結(jié)核性炎癥組、肺結(jié)核組及惡性肺結(jié)節(jié)組動脈期標(biāo)準(zhǔn)化碘濃度及40-90ke V能譜曲線斜率存在差異,其中非結(jié)核性炎癥組的標(biāo)準(zhǔn)化碘濃度及40-90ke V能譜曲線斜率均數(shù)最大,惡性肺結(jié)節(jié)組次之,肺結(jié)核組最小。而三組動脈期有效原子序數(shù)間差異沒有統(tǒng)計(jì)學(xué)意義。非結(jié)核性炎癥組與肺結(jié)核組、非結(jié)核性炎癥組與惡性肺結(jié)節(jié)組、肺結(jié)核組與惡性肺結(jié)節(jié)組動脈期標(biāo)準(zhǔn)碘濃度及40-90ke V能譜曲線斜率均有統(tǒng)計(jì)學(xué)差異。肺腺癌組、肺鱗癌組動脈期標(biāo)準(zhǔn)化碘濃度、有效原子序數(shù)及40-90ke V能譜曲線斜率均有統(tǒng)計(jì)學(xué)差異。肺腺癌組標(biāo)準(zhǔn)碘濃度及有效原子序數(shù)均值大于肺鱗癌組。結(jié)論:動脈期標(biāo)準(zhǔn)化碘濃度及40-90ke V能譜曲線斜率可作為非結(jié)核性炎癥、肺結(jié)核及惡性肺結(jié)節(jié)的鑒別診斷的指標(biāo),有助于三者的鑒別,亦可作為肺腺癌與肺鱗癌鑒別診斷的指標(biāo)。能譜CT成像參數(shù)中的動脈期有效原子序數(shù)在鑒別非結(jié)核性炎癥、肺結(jié)核及惡性肺結(jié)節(jié)中的價(jià)值有限,但可作為肺腺癌與肺鱗癌鑒別診斷的指標(biāo)。
[Abstract]:Objective: to measure the concentration of iodine, the effective atomic number and the slope of the energy spectrum curve of 40 ~ 90ke V in solitary pulmonary noduleus (SPNs) by means of quantitative measurement of the concentration of iodine, the effective atomic number and the slope of the energy spectrum curve of the solitary pulmonary noduleus. Methods: from September 2013 to December 2016, 85 inpatients with solitary pulmonary nodules, 49 males and 36 females, were selected. The mean age was 46.7 years (30-78 years). All the patients in the group underwent double phase enhanced chest scan with energy dispersive scanning mode (GSI), all the patients were confirmed by surgical pathology or biopsy, including 17 cases of non-tuberculous inflammation. 25 cases of pulmonary tuberculosis, 43 cases of malignant nodules, including 19 cases of adenocarcinoma and 24 cases of squamous cell carcinoma. Effective atomic number and 40-90ke V spectral curve slope. All data were analyzed by SPSS statistical analysis software (version 17.0). The quantitative data were expressed as mean 鹵standard deviation, for non-tuberculous inflammation, pulmonary tuberculosis, malignant pulmonary nodules and lung adenocarcinoma, There were significant differences in standardized iodine concentration, effective atomic number and 40-90ke V energy spectrum curve slope of lung squamous cell carcinoma by t test (P0.05). Results: Non-tuberculous inflammation group, In pulmonary tuberculosis group and malignant pulmonary nodule group, there were differences in standardized iodine concentration and 40-90ke V curve slope in arterial phase. The mean value of standardized iodine concentration and 40-90ke V energy spectrum curve in non-tuberculous inflammation group was the highest, followed by malignant pulmonary nodule group. The pulmonary tuberculosis group was the smallest. There was no significant difference in the effective atomic number among the three groups. The non-tuberculous inflammation group and the pulmonary tuberculosis group, the non-tuberculous inflammation group and the malignant pulmonary nodule group, There were significant differences between pulmonary tuberculosis group and malignant pulmonary nodule group in arterial phase standard iodine concentration and 40-90ke V curve slope, the arterial phase standardized iodine concentration in lung adenocarcinoma group, lung squamous cell carcinoma group, lung squamous cell carcinoma group, lung adenocarcinoma group, lung squamous cell carcinoma group, lung squamous cell carcinoma group, The mean values of standard iodine concentration and effective atomic number in lung adenocarcinoma group were higher than those in lung squamous cell carcinoma group. Conclusion: standardized iodine concentration and 40-90ke V energy spectrum curve slope can be obtained in arterial phase. As a non-tuberculous inflammation, The differential diagnosis of pulmonary tuberculosis and malignant pulmonary nodules is helpful to the differential diagnosis of pulmonary adenocarcinoma and lung squamous cell carcinoma. The effective atomic number of arterial phase in the parameters of EDS imaging is useful in differentiating non-tuberculous inflammation. The value of pulmonary tuberculosis and malignant pulmonary nodules is limited, but it can be used as a differential diagnosis between lung adenocarcinoma and lung squamous cell carcinoma.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R730.44;R734.2

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