本文關(guān)鍵詞： 能譜CT 肺癌骨轉(zhuǎn)移瘤 多發(fā)性骨髓瘤　出處：《山西醫(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(guò)對(duì)肺癌溶骨性脊柱轉(zhuǎn)移瘤和多發(fā)性骨髓瘤(multiple myeloma,MM)脊柱病灶進(jìn)行寶石能譜CT掃描(GSI),測(cè)量并分析兩組病灶單能量下的CT值和能譜曲線斜率,探究寶石能譜CT(GSI)在鑒別肺癌溶骨性脊柱轉(zhuǎn)移瘤和多發(fā)性骨髓瘤脊柱病灶的應(yīng)用潛力。方法:分析2016年4月至2017年1月期間在山西醫(yī)科大學(xué)第二醫(yī)院行能譜CT掃描的原發(fā)性肺癌伴脊柱溶骨性骨轉(zhuǎn)移瘤患者17例及多發(fā)性骨髓瘤伴脊柱病灶的患者25例的圖像,將掃描所得到的單能量原始數(shù)據(jù)重建成層厚、層間距為1.25 mm的薄層圖像,(1)比較兩種脊柱惡性腫瘤病灶感興趣區(qū)在40~140keV(能量間隔為5keV)各單能量圖像下的CT值,(2)繪制不同病灶的能譜曲線圖,并計(jì)算分析能譜曲線斜率(本研究選40keV-90keV為參考點(diǎn))即CT(40keV)-CT(90keV)/(90keV-40keV),對(duì)以上所得到的數(shù)據(jù)進(jìn)行兩樣本的Mann Whitney U檢驗(yàn)的統(tǒng)計(jì)學(xué)分析。結(jié)果:(1)肺癌骨轉(zhuǎn)移病灶在40keV~90keV對(duì)應(yīng)的CT值的中位數(shù)高于骨髓瘤病灶,P0.05,差別有統(tǒng)計(jì)學(xué)意義;(2)肺癌轉(zhuǎn)移灶能譜曲線斜率(40keV-90keV為參考點(diǎn))的中位數(shù)大于骨髓瘤病灶,P0.05,差別有統(tǒng)計(jì)學(xué)意義;(3)平掃后肺癌骨轉(zhuǎn)移病灶與骨髓瘤病灶在95keV~140keV對(duì)應(yīng)的CT值的中位數(shù)相互比較差別不大,P0.05,差別不具有統(tǒng)計(jì)學(xué)意義,結(jié)論:能譜CT能夠準(zhǔn)確測(cè)量并比較肺癌溶骨性脊柱骨轉(zhuǎn)移和多發(fā)性骨髓瘤脊柱病灶的單能量下CT值及能譜曲線斜率,為臨床提供更多有價(jià)值的定量影像學(xué)信息。其在脊柱的肺癌骨轉(zhuǎn)移及多發(fā)性骨髓瘤的鑒別診斷中具有一定的應(yīng)用價(jià)值。
[Abstract]:Objective: to study the value of gemstone energy dispersive computed tomography (SPECT) in the diagnosis of multiple myeloma (MM) and osteolytic spinal metastases of lung cancer. The CT value and the slope of the energy spectrum curve of the two groups were measured and analyzed. A study on Gem Energy Spectrum (CTG GSI). Potential in differentiating osteolytic spinal metastases from multiple myeloma spinal lesions in lung cancer. Methods:. From April 2016 to January 2017, 17 cases of primary lung cancer with osteolytic bone metastases and multiple myeloma with spinal lesions were analyzed in the second Hospital of Shanxi Medical University. Images were obtained from 25 patients. The original data of single energy are reconstructed into thin-layer images with thickness of layer and interval of 1.25 mm. 1) to compare the CT values of two types of spinal malignant tumors under 40 ~ 140keV (energy interval of 5 Kev) single energy images to draw the energy spectrum curves of different lesions. The slope of the energy spectrum curve (40keV-90keV as reference point) was calculated and analyzed. Statistical analysis of Mann Whitney U test of two samples for the data obtained above. Results: 1). The median CT value of bone metastases of lung cancer at 40 keV and 90 Kev was higher than that of myeloma. P0.05, the difference was statistically significant. (2) the median of energy spectrum curve slope of metastatic focus of lung cancer (40keV-90keV) was higher than that of myeloma (P 0.05), the difference was statistically significant. (3) there was no significant difference between the median CT value of bone metastases and myeloma lesions in 95 keV 140keV after plain scan (P 0.05). Conclusion: energy dispersive CT can accurately measure and compare the value of single energy CT and the slope of energy spectrum curve of osteolytic spinal bone metastasis and multiple myeloma of lung cancer. It can provide more valuable quantitative imaging information for clinical application in the differential diagnosis of bone metastasis and multiple myeloma of spinal lung cancer.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R733.3;R738;R730.44

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