实用医学杂志2024，Vol.40Issue(14)：2003-2008,6.DOI:10.3969/j.issn.1006-5725.2024.14.017
宽体能谱CT参数在鉴别诊断肺癌纵隔转移、非转移淋巴结与反应性增生淋巴结中的价值
Differential diagnostic value of wide-body spectral CT parameters in mediastinal metastatic,non-metastatic lymph nodes of lung cancer patients and reactive hyperplastic lymph nodes
摘要
Abstract
Objective The evaluation of lymph node properties before lung cancer surgery has a great impact with the choice of surgical methods.Although there are various examination methods,many methods have invasive or accuracy problems.In order to improve the accuracy of diagnosis,we mainly discuss the value of wide-body spectral CT in the differential diagnosis of mediastinal metastatic lymph nodes,non-metastatic lymph nodes in lung cancer patients and reactive hyperplastic lymph nodes.Methods The clinical and imaging data of 64 patients with lung cancer and 28 patients with pulmonary inflammatory lesions were retrospectively analyzed.All patients underwent plain scan and enhanced dual-phase spectral CT scan.The size,density,three-phase IC,NIC,and λHU of lymph nodes in metastatic,non-metastatic and inflammatory reactive hyperplasia groups were measured on 70 keV single-energy images and iodine-based images,respectively.The single-factor variance and Kruskal-Wallis H rank sum test were used to analyze and compare the differences.Results The short diameter of metastatic lymph nodes was larger than that of non-metastatic lymph nodes and reactive hyperplastic lymph nodes(P<0.001).The plain scan density of reactive hyperplastic lymph nodes was higher than that of metastatic lymph nodes(P<0.001),but there was no significant difference between non-metastatic lymph nodes(P=0.325).The CT values of reactive hyperplastic lymph nodes in arterial phase and venous phase were higher than those of metastatic and non-metastatic lymph nodes(P<0.05).Except for NIC in arterial phase,IC,NIC and λHU in plain scan,IC and λHU in arterial phase,IC,NIC and λHU in venous phase of reactive hyperplastic lymph nodes and metastatic lymph nodes were statistically significant(all P<0.05).There was no significant difference in IC,NIC and λHU between reactive hyperplastic lymph nodes and non-metastatic lymph nodes in plain scan,arterial phase and venous phase(all P>0.05).Conclusion The quantitative and spectral curve slope of iodine in mediastinal metastatic lymph nodes of lung cancer were basically lower than those in reactive hyperplastic lymph nodes.The quantitative parameters of spectral CT had certain diagnostic efficacy in differentiating metastatic lymph nodes and reactive hyperplastic lymph nodes,while the spectral parameters of non-metastatic lymph nodes and reactive hyperplastic lymph nodes were not statistically significant.关键词
肺癌/纵隔淋巴结/能谱CT/诊断效能Key words
lung cancer/mediastinal lymph nodes/spectral CT/efficiency分类
医药卫生引用本文复制引用
郑思捷,向佳,陈茜彤,卢颖欣,刘韵,陈淮,黄绥丹..宽体能谱CT参数在鉴别诊断肺癌纵隔转移、非转移淋巴结与反应性增生淋巴结中的价值[J].实用医学杂志,2024,40(14):2003-2008,6.基金项目
广东省医学科研基金项目(编号:A2024521) （编号:A2024521）
广州医科大学本科生创新创业培育项目 （）
广东省钟南山医学基金会(编号:ZNSXS-20230001) （编号:ZNSXS-20230001）
