中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2021, Vol. 43 ›› Issue (1): 53-56.doi: 10.3881/j.issn.1000-503X.12514

• 论著 • 上一篇    下一篇

小细胞肺癌纵隔淋巴结转移和纵隔结节病能谱CT的表现差异

马拓1,2,曹立秀2,李会菊2,任红亮2,陈大鹏2,高媛2,李志东2,赵新斌1(),董思圻3   

  1. 1华北理工大学附属医院CT室,河北唐山 063000
    2唐山市人民医院 CT室 , 河北唐山 063000
    3唐山市人民医院 医务科, 河北唐山 063000
  • 收稿日期:2019-11-20 出版日期:2021-02-28 发布日期:2021-03-05
  • 通讯作者: 赵新斌 E-mail:zhaoxinbinchenlei@163.com
  • 基金资助:
    2019年度河北医学科学研究重点课题计划(20191622)

Differences of Energy Spectrum CT Findings between Small Cell Lung Cancer with Mediastinal Lymph Node Metastasis and Mediastinal Sarcoidosis

MA Tuo1,2,CAO Lixiu2,LI Huiju2,REN Hongliang2,CHEN Dapeng2,GAO Yuan2,LI Zhidong2,ZHAO Xinbin1(),DONG Siqi3   

  1. 1Department of CT,North China University of Science and Technology Affiliated Hospital,Tangshan,Heibei 063000,China
    2Department of CT, Tangshan People’s Hospital,Tangshan,Hebei 063000,China
    3Medical Department,Tangshan People’s Hospital,Tangshan,Hebei 063000,China
  • Received:2019-11-20 Online:2021-02-28 Published:2021-03-05
  • Contact: ZHAO Xinbin E-mail:zhaoxinbinchenlei@163.com
  • Supported by:
    Supported by the Key Project of Hebei Medical Science Research in 2019(20191622)

摘要:

目的 比较小细胞肺癌(SCLC)纵隔淋巴结转移和纵隔结节病能谱CT的表现差异。方法 以2018年1月至2019年6月在唐山市人民医院就诊经支气管镜活检病理证实的肺内未见确切原发灶的SCLC纵隔淋巴结转移患者25例(SCLC组)及纵隔结节病患者26例(结节病组)为研究对象,行能谱CT增强扫描,对比不同单能量水平下的CT值、碘含量、水含量、能谱曲线斜率等参数,比较SCLC纵隔淋巴结转移和纵隔结节病的表现差异。结果 SCLC组动脉期40~80 keV段单能量CT值均显著高于结节病组(P均<0.05),90~140 keV段单能量CT值与结节病组相比差异无统计学意义(P均>0.05);SCLC组静脉期40~90 keV段单能量CT值显著高于结节病组(P均<0.05),100~140 keV段单能量CT值与结节病组相比差异无统计学意义(P均>0.05)。SCLC组动、静脉期碘浓度分别为(11.56±4.06)和(13.39±0.87)μg/cm 3,均明显大于结节病组的(4.43±3.85)(t=11.564,P=0.026)和(7.23±2.71)μg/cm 3(t=13.653,P=0.021);SCLC组动、静脉期水浓度分别为(1040.67±5.62)和(1035.23±8.57)mg/cm 3,与结节病组的(1028.87±6.94)(t=3.155,P=1.861)和(1021.53±4.68)mg/cm 3(t=3.265,P=1.687)相比差异均无统计学意义。SCLC组静脉期40~70 keV、70~100 keV、100~140 keV的斜率均明显高于结节病组(P均<0.05);两组间动脉期40~70 keV、70~100 keV、100~140 keV的斜率差异均无统计学意义(P均>0.05)。结论 能谱扫描可在动脉期40~80 keV、静脉期40~90 keV单能量CT值,动、静脉期碘浓度及静脉期能谱曲线斜率上显示SCLC纵隔淋巴结转移和纵隔结节病的差异。

关键词: 小细胞肺癌, 结节病, 转移淋巴结, 能谱CT

Abstract:

Objective To compare the differences of energy spectrum CT between small cell lung cancer(SCLC)with mediastinal lymph node metastasis and mediastinal sarcoidosis.Methods Twenty-five SCLC patients with mediastinal lymph node metastasis(SCLC group)and 26 patients with mediastinal sarcoidosis(sarcoidosis group)confirmed by bronchoscopy and biopsy in Tangshan People’s Hospital from January 2018 to June 2019 were selected as the research objects.The CT value,iodine concentration,water concentration and energy spectrum curve slope under different single energy levels were compared between SCLC group and sarcoidosis group.Results The single-energy CT values of 40-80 keV segments in the arterial phase of the SCLC group were significantly higher than those in the sarcoidosis group(all P <0.05).The single-energy CT values of 90-140 keV segments were not significantly different from those in the sarcoidosis group(all P >0.05).The single-energy CT values of 40-90 keV segments in venous phase of the SCLC group were significantly higher than those of the sarcoidosis group(all P <0.05),and the single-energy CT values of 100-140 keV segments were not significantly different from those of the sarcoidosis group(all P >0.05).The concentrations of iodine in the arterial phase and venous phase of the SCLC group were(11.56±4.06)μg/cm 3 and(13.39±0.87)μg/cm 3,respectively,which were significantly higher than those [(4.43±3.85)μg/cm 3,t=11.564,P=0.026;(7.23±2.71)μg/cm 3,t=13.653,P=0.021] in the sarcoidosis group.The concentrations of water in the arterial and venous phases of the SCLC group were(1040.67±5.62)mg/cm 3 and(1035.23±8.57)mg/cm 3,respectively,which showed no statistically significant difference compared with those [(1028.87±6.94)mg/cm 3,t=3.155,P=1.861;(1021.53±4.68)mg/cm 3,t=3.265,P=1.687] in the sarcoidosis group.The slopes of energy spectrum curve at 40-70 keV,70-100 keV and 100-140 keV in venous phase of the SCLC group were significantly higher than those of the sarcoidosis group(all P <0.05),whereas they showed no significant difference between the two groups in arterial phase(all P >0.05).Conclusion The differences between SCLC with mediastinal lymph node metastasis and mediastinal sarcoidosis can be shown on the single-energy CT values of 40-80 keV in arterial phase and 40-90 keV in venous phase,iodine concentrations in arterial phase and venous phase,and the slope of energy spectrum curve in venous phase.

Key words: small cell lung cancer, sarcoidosis, metastatic lymph nodes, energy spectrum CT

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