本文選題：肺癌 + 能譜成像　； 參考：《長(zhǎng)江大學(xué)》2017年碩士論文

【摘要】：目的:討論寶石能譜CT成像技術(shù)(Gemstone spectral imaging,GSI)在不同病理類型肺癌中鑒別診斷的價(jià)值。材料和方法:回顧性分析2015年5月至2016年10月于荊州市第一人民醫(yī)院行寶石能譜CT檢查并經(jīng)手術(shù)或CT引導(dǎo)下穿刺病理證實(shí)的106例肺癌(肺鱗癌39例、肺腺癌42例、小細(xì)胞肺癌17例、大細(xì)胞肺癌8例)患者的能譜CT資料,選取動(dòng)脈期掃描數(shù)據(jù),測(cè)量不同病理類型肺癌病灶的鈣含量、水含量、有效原子序數(shù)、40~80keV間的能譜衰減曲線斜率以及動(dòng)脈期的標(biāo)準(zhǔn)化碘濃度(Normalized Iodine Concentration,NIC),分析比較各項(xiàng)能譜數(shù)據(jù)在不同病理類型肺癌鑒別診斷的價(jià)值。結(jié)果:1.肺鱗癌組、肺腺癌組、肺小細(xì)胞肺癌組、肺大細(xì)胞肺癌組的標(biāo)準(zhǔn)化碘濃度分別為:0.07±0.03、0.12±0.06、0.05±0.03、0.05±0.02;肺鱗癌組與肺腺癌組、肺鱗癌組與肺小細(xì)胞肺癌組、肺鱗癌組與肺大細(xì)胞肺癌組、肺腺癌與肺大細(xì)胞肺癌組、肺腺癌組與肺小細(xì)胞肺癌組之間差異有統(tǒng)計(jì)學(xué)意義(P0.05);肺小細(xì)胞肺癌組與肺大細(xì)胞肺癌組之間沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05)。2.肺鱗癌組、肺腺癌組、肺小細(xì)胞肺癌組、肺大細(xì)胞肺癌組的鈣含量(mg/ml)分別為9.59±5.29、5.83±3.84、2.65±1.47、4.08±1.55;肺鱗癌組與肺腺癌組、肺鱗癌組與肺小細(xì)胞肺癌組、肺鱗癌組與肺大細(xì)胞肺癌組、肺小細(xì)胞肺癌組與肺大細(xì)胞肺癌組之間差異有統(tǒng)計(jì)學(xué)意義(P0.05);肺腺癌與肺大細(xì)胞肺癌組之間沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05);3.肺鱗癌組、肺腺癌組、肺小細(xì)胞肺癌組、肺大細(xì)胞肺癌組的水含量(mg/ml)分別為1060.63±34.87、1038.56±28.36、1040.88±17.83、1036.84±8.26;肺鱗癌組與肺腺癌組、肺鱗癌組與肺小細(xì)胞肺癌組、肺鱗癌組與肺大細(xì)胞肺癌組之間差異有統(tǒng)計(jì)學(xué)意義(P0.05);肺腺癌與肺大細(xì)胞肺癌組、肺腺癌組與肺小細(xì)胞肺癌組、肺小細(xì)胞肺癌組與肺大細(xì)胞肺癌組之間沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05);4.肺鱗癌組、肺腺癌組、肺小細(xì)胞肺癌組、肺大細(xì)胞肺癌組的有效原子序數(shù)分別為7.87±0.27、8.01±0.31、7.73±0.32、7.90±0.46;肺鱗癌組與肺腺癌組、肺腺癌組與肺小細(xì)胞肺癌組之間差異有統(tǒng)計(jì)學(xué)意義(P0.05);肺鱗癌組與肺小細(xì)胞肺癌組、肺鱗癌組與肺大細(xì)胞肺癌組、肺腺癌與肺大細(xì)胞肺癌組、肺小細(xì)胞肺癌組與肺大細(xì)胞肺癌組之間沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05);5.肺鱗癌組、肺腺癌組、肺小細(xì)胞肺癌組、肺大細(xì)胞肺癌組的40~80Kev能譜曲線斜率分別為0.77±0.49、1.28±0.68、0.29±0.14、0.44±0.28;肺鱗癌組與肺腺癌組、肺鱗癌組與肺小細(xì)胞肺癌組、肺腺癌組與肺小細(xì)胞肺癌組、肺腺癌與肺大細(xì)胞肺癌組之間差異有統(tǒng)計(jì)學(xué)意義(P0.05);肺鱗癌組與肺大細(xì)胞肺癌組、肺小細(xì)胞肺癌組與肺大細(xì)胞肺癌組之間沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:不同類型肺癌具有不同的能譜特征參數(shù),其中肺腺癌組的標(biāo)準(zhǔn)碘含量高于鱗癌組、肺大細(xì)胞肺癌及肺小細(xì)胞肺癌組;肺鱗癌組病灶的鈣含量平均值大于肺腺癌組、肺大細(xì)胞肺癌及肺小細(xì)胞肺癌組;通過(guò)對(duì)肺癌瘤體內(nèi)鈣含量、水含量、有效原子序數(shù)、40~80keV間的能譜衰減曲線斜率以及動(dòng)脈期的標(biāo)準(zhǔn)化碘濃度分析比較,可以幫助鑒別診斷不同來(lái)源的肺癌。
[Abstract]:Objective: to discuss the value of gemstone CT imaging (Gemstone spectral imaging, GSI) in the differential diagnosis of different pathological types of lung cancer. Materials and methods: a retrospective analysis of 106 cases of lung cancer (lung scale) confirmed by Gemstone spectrum CT examination and pathology confirmed by surgery or CT guided puncture from May 2015 to October 2016 in the first people's Hospital in Jingzhou. 39 cases of cancer, 42 cases of adenocarcinoma of lung, 17 cases of small cell lung cancer, 8 cases of large cell lung cancer, CT data, arterial phase scanning data were selected to measure the calcium content, water content, effective atomic number, the slope of energy spectrum attenuation curve between 40~80keV and the standardized iodine concentration (Normalized Iodine Concentrati) of the arterial phase (Normalized Iodine Concentrati). On, NIC), analysis and comparison of the value of various spectral data in the differential diagnosis of lung cancer in different pathological types. Results: the standard iodine concentration in 1. lung squamous cell carcinoma group, lung adenocarcinoma group, lung small cell lung cancer group and lung large cell lung cancer group was 0.07 + 0.03,0.12 + 0.06,0.05 + 0.03,0.05 + 0.02, lung squamous cell carcinoma group and lung adenocarcinoma group, lung squamous cell carcinoma group and lung small cell lung Cancer group, lung large cell lung cancer group, lung adenocarcinoma and lung large cell lung cancer group, lung adenocarcinoma group and lung small cell lung cancer group have significant difference (P0.05), there is no statistical significance between lung small cell lung cancer group and lung large cell lung cancer group (P0.05).2. lung squamous cell carcinoma group, lung adenocarcinoma group, lung small cell lung cancer group, lung large cell lung The calcium content (mg/ml) in the cancer group was 9.59 + 5.29,5.83 + 3.84,2.65 + 1.47,4.08 + 1.55; lung squamous cell carcinoma group and lung adenocarcinoma group, lung squamous cell carcinoma group and lung small cell lung cancer group, lung squamous cell carcinoma group and lung large cell lung cancer group, pulmonary small cell lung cancer group and lung large cell lung cancer group (P0.05), lung adenocarcinoma and lung large cell lung cancer group There was no statistical significance (P0.05); the water content of 3. lung squamous cell carcinoma group, lung adenocarcinoma group, lung small cell lung cancer group and lung large cell lung cancer group was 1060.63 + 34.871038.56 + 28.361040.88 + 17.831036.84 + 8.26, lung squamous cell carcinoma group and lung adenocarcinoma group, lung squamous cell carcinoma group and lung small cell lung cancer group, lung squamous cell carcinoma group and lung large cell lung cancer group The difference was statistically significant (P0.05); there was no statistical significance between lung adenocarcinoma and lung large cell lung cancer group, lung adenocarcinoma group and lung small cell lung cancer group, lung small cell lung cancer group and lung large cell lung cancer group (P0.05), and the effective atomic number of 4. lung squamous cell carcinoma group, lung adenocarcinoma group, lung small cell lung cancer group and lung large cell lung cancer group was 7.87 + 0.27,8.01, respectively. The difference between lung squamous cell carcinoma group and lung adenocarcinoma group, lung adenocarcinoma group and lung small cell lung cancer group was statistically significant (P0.05), pulmonary squamous cell carcinoma group and lung small cell lung cancer group, lung squamous cell carcinoma group and lung large cell lung cancer group, lung adenocarcinoma and lung large cell lung cancer group, pulmonary small cell lung cancer group and lung large cell lung cancer group were not unified. Study significance (P0.05); 5. lung squamous cell carcinoma group, lung adenocarcinoma group, lung small cell lung cancer group and lung large cell lung cancer group were 0.77 + 0.49,1.28 + 0.68,0.29 + 0.14,0.44 + 0.28; lung squamous cell carcinoma group and lung adenocarcinoma group, lung squamous cell carcinoma group and lung small cell lung cancer group, lung adenocarcinoma group and lung small cell lung cancer group, lung adenocarcinoma and lung large cell There was significant difference between lung cancer groups (P0.05). There was no statistical significance between lung squamous cell carcinoma group and lung large cell lung cancer group, lung small cell lung cancer group and lung large cell lung cancer group (P0.05). Conclusion: different types of lung cancer have different characteristic parameters of energy spectrum, and the standard iodine content of lung adenocarcinoma group is higher than that of squamous cell carcinoma group, lung large cell lung cancer and lung The average calcium content of the lesions in the lung squamous cell carcinoma group is greater than that of the lung adenocarcinoma group, the lung large cell lung cancer and the lung small cell lung cancer group. By comparing the calcium content, the water content, the effective atomic number, the slope of the energy spectrum attenuation curve between 40~80keV and the standard iodine concentration in the arterial phase, the differential diagnosis can help differential diagnosis. Lung cancer of the same origin.

【學(xué)位授予單位】：長(zhǎng)江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R734.2;R730.44

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