孤立性肺结节的CT形态学特征结合GSI模式的诊断学研究

本研究探讨CT联合能谱成像(GSI)模式诊断孤立性肺结节的临床价值。选取经肺穿刺活检或手术病理学证实的肺孤立性结节患者110例(110个肺结节),对患者的CT平扫、GSI平扫资料进行分析。根据病理学结果分为良性组(炎性结节、非典型腺瘤样增生)41例、恶性组(肺癌小结节)69例,对比两组患者的肺小结节形态学特征综合评分、动静脉期的能谱曲线斜率、40 keV CT值、标准化碘浓度(NIC)的差异。结果显示,恶性组患者的毛刺征和棘突征、分叶征、血管集束征、胸膜凹陷征、支气管征、病灶内钙化、病灶强化值及孤立性肺结节形态学特征总分均高于良性组(P<0.05);恶性组患者的动脉期、静脉期的能谱曲线斜率、40 keV CT值、NIC均低于良性组(P<0.05)。肺部孤立性恶性结节的形态学特征与肺部良性结节差异显著,恶性结节的能谱曲线斜率、40 keV CT值、NIC值与良性结节差异明显。因此,综合分析结节的形态学特征及GSI参数对其良恶性诊断具有重要意义。

Diagnostic Study of CT Morphological Features of Solitary Pulmonary Nodules Combined with GSI Mode

This study explored the clinical value of CT morphological features combined with gemstone spectrum imaging(GSI) in the diagnosis of solitary pulmonary nodules. A total of 110 patients(110 lung nodules) with solitary pulmonary nodules confirmed by lung biopsy or surgical pathology were selected for research. The CT plain scan and GSI plain scan data of patients were analyzed. According to the pathological results, there were 41 cases in the benign group(inflammatory nodules, atypical adenomatous hyperplasia) and 69 cases in the malignant group(small lung cancer nodules). The differences in the comprehensive scores of the morphological characteristics of small lung nodules, the slope of the energy spectrum curve in the arteriovenous phase, the 40 keV CT value, and the NIC were compared between the two groups of patients. The total scores of burr syndrome and spinous process sign, lobular sign, vascular cluster sign, pleural depression sign, bronchial sign, intralesional calcification, lesion enhancement value, and solitary pulmonary nodule morphological characteristics of the malignant group were all higher than those of the benign group(P<0.05). The slope of the energy spectrum curve, 40 keV CT value and NIC of the arterial phase and venous phase of the malignant group were lower than those of the benign group(P<0.05). The morphological characteristics of solitary malignant pulmonary nodules are significantly different from benign pulmonary nodules. The energy spectrum curve slope,40 keV CT value and NIC value of malignant nodules are significantly different from those of benign nodules.Comprehensive analysis of the morphological characteristics of nodules and GSI parameters are of great significance to the diagnosis of benign and malignant.