本文選題：肺腫瘤 + 肺炎性病變��； 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討寶石能譜CT成像定量分析功能在鑒別診斷肺癌、肺炎性病變和肺結(jié)核中的價(jià)值。方法:收集經(jīng)能譜CT增強(qiáng)掃描的78例肺結(jié)節(jié)或腫塊患者,根據(jù)病理及治療后隨訪(fǎng)結(jié)果分為肺癌組(38例)、肺結(jié)核組(20例)及肺炎性病變組(20例),分別測(cè)量動(dòng)、靜脈期病灶周?chē)鷧^(qū)的40-100keV區(qū)間間隔為10的單能量CT值、碘濃度(IC)、水濃度(WC)及能譜曲線(xiàn)斜率,并測(cè)量肺炎性病變和肺癌組病灶中央?yún)^(qū)的碘濃度,同時(shí)測(cè)量同層面胸主動(dòng)脈或鎖骨下動(dòng)脈的碘濃度及水濃度,并計(jì)算病灶的標(biāo)準(zhǔn)化碘濃度(NIC)及標(biāo)準(zhǔn)化水濃度(NWC),同時(shí)計(jì)算病灶中央?yún)^(qū)與周?chē)鷧^(qū)標(biāo)準(zhǔn)化碘濃度之差的絕對(duì)值(dNIC)。三組間各參數(shù)的差異性比較采用方差分析或秩和檢驗(yàn),兩組間差異性比較采用t檢驗(yàn)。繪制ROC曲線(xiàn),確定各能譜參數(shù)鑒別診斷三組病變的臨界值及其診斷效能。結(jié)果:三組病變間的動(dòng)、靜脈期病灶周?chē)鷧^(qū)單能量CT值(40-100e V)、IC、NIC及λHU差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。三組間WC及NWC差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩兩比較結(jié)果為肺炎性病變和結(jié)核組、肺癌組和結(jié)核組間差異均有統(tǒng)計(jì)意義(P0.05),而肺炎性病變和肺癌組間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。肺炎組和肺癌組間中央?yún)^(qū)IC、NIC及周?chē)鷧^(qū)與中央?yún)^(qū)NIC的差值(dNIC=NICper-NICce n)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。靜脈期NIC=0.325、0.297時(shí),鑒別診斷肺炎性病變與肺結(jié)核、肺癌與肺結(jié)核的靈敏度分別為95%、97%,特異度分別為85%、75%。動(dòng)脈期病灶中央?yún)^(qū)NIC=0.062時(shí),鑒別肺癌與肺炎性病變的靈敏度和特異度分別是95%、79%。結(jié)論:寶石能譜CT的多參數(shù)定量分析功能可以用于肺癌、肺結(jié)核及肺炎性病變的鑒別診斷。
[Abstract]:Objective: to evaluate the value of quantitative analysis of gemstone energy dispersive CT imaging in differential diagnosis of lung cancer, pneumonia and pulmonary tuberculosis. Methods: Seventy-eight patients with pulmonary nodules or masses who were examined by EDS CT were divided into lung cancer group (n = 38) and pulmonary tuberculosis group (n = 20) and pneumonitis group (n = 20). The single energy CT value, iodine concentration, water concentration and WCC) and the slope of the energy spectrum curve were measured at 40-100keV interval of 10 in the perifocal area of venous phase. The iodine concentration in the central area of the lesion was measured in the patients with pneumonitis and lung cancer. The iodine concentration and water concentration of thoracic aorta or subclavian artery were measured at the same time. The standardized iodine concentration (NICs) and the standard water concentration (NWCU) of the lesion were calculated. The absolute value of the difference of the standardized iodine concentration between the central area of the lesion and the surrounding area was calculated. Analysis of variance or rank sum test were used to compare the differences between the three groups, and t test was used to compare the differences between the two groups. The ROC curve was drawn to determine the critical value and diagnostic efficacy of each energy spectrum parameter for differential diagnosis of three groups of lesions. Results: there were significant differences in ICNIC and 位 Hu between the three groups (P 0.05). There was no significant difference in WC and NWC among the three groups (P 0.05). The difference between lung cancer group and tuberculosis group was significant (P 0.05), but there was no significant difference between lung cancer group and lung cancer group (P 0.05). The difference of Nic in central and peripheral areas between pneumonia group and lung cancer group was statistically significant (P 0.05). The sensitivity of lung cancer and pulmonary tuberculosis was 95 / 97, and the specificity was 8575 / 7575, respectively. The sensitivity and specificity in differentiating lung cancer from pneumonic lesions were 95% and 79% respectively. Conclusion: multiparameter quantitative analysis of gemstone energy dispersive CT can be used in differential diagnosis of lung cancer, pulmonary tuberculosis and pneumonitis.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R563;R816.41

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