患者局灶性机化性肺炎：使用双能量谱计算机断层扫描与孤立性细支气管肺泡癌的鉴别
Focal organizing pneumonia in patients: differentiation from solitary bronchioloalveolar carcinoma using dual-energy spectral computed tomography.
作者信息
Zhang Guojin, Cao Yuntai, Zhang Jing, Zhao Zhiyong, Zhang Wenjuan, Huang Lele, Zhang Zhuoli, Zhou Junlin
机构信息
Second Clinical School, Lanzhou University Lanzhou, China.
Key Laboratory of Medical Imaging of Gansu Province Lanzhou, China.
出版信息
Am J Transl Res. 2020 Jul 15;12(7):3974-3983. eCollection 2020.
OBJECTIVE
To explore the utility of dual-energy spectral computed tomography (CT) in the differential diagnosis of focal organizing pneumonia (FOP) and solitary bronchioloalveolar carcinoma (S-BAC).
MATERIALS AND METHODS
The institutional review board approved this study and waived the requirement for informed consent. It is a retrospective study. A total of 105 patients (62 with FOP and 43 with S-BAC) enrolled and all patients have contrast enhanced spectral CT including the arterial phase (AP) and venous phase (VP). During AP and VP, CT, CT, and CT values, iodine concentration (IC), water concentration (WC), and effective atomic number (Zeff) were measured on monochromatic and iodine-based material decomposition images, and the slope of the spectral curve (λ) was calculated. The two-sample t-test was used to compare quantitative parameters, and receiver operating characteristic (ROC) curves were generated to calculate diagnostic efficacies.
RESULTS
For AP, CT and CT values, IC, WC, Zeff, λ, and λ measurements, there were significantly higher in patients with S-BAC than in those with FOP (P < 0.05). However, these quantitative parameters of VP were significantly lower in patients with S-BAC than in those with FOP (P < 0.05). ROC curve analysis revealed that the combination of all quantitative parameters in AP and VP provided the best diagnostic performance in distinguishing S-BAC from FOP (area under the ROC curve, 93.1%; sensitivity, 95.3%; specificity, 77.4%).
CONCLUSIONS
Dual-energy spectral CT has the potential to identify S-BAC and FOP.
目的
探讨双能谱计算机断层扫描（CT）在局灶性机化性肺炎（FOP）与孤立性细支气管肺泡癌（S-BAC）鉴别诊断中的应用价值。
材料与方法
本研究经机构审查委员会批准并豁免知情同意要求。这是一项回顾性研究。共纳入105例患者（62例FOP患者和43例S-BAC患者），所有患者均行对比增强光谱CT检查，包括动脉期（AP）和静脉期（VP）。在AP和VP期，在单色和基于碘的物质分解图像上测量CT值、碘浓度（IC）、水浓度（WC）和有效原子序数（Zeff），并计算光谱曲线斜率（λ）。采用两样本t检验比较定量参数，并绘制受试者工作特征（ROC）曲线以计算诊断效能。
结果
对于AP期的CT值、IC、WC、Zeff、λ及λ测量值，S-BAC患者显著高于FOP患者（P<0.05）。然而，S-BAC患者VP期的这些定量参数显著低于FOP患者（P<0.05）。ROC曲线分析显示，AP期和VP期所有定量参数的组合在区分S-BAC和FOP方面具有最佳诊断性能（ROC曲线下面积为93.1%；敏感度为95.3%；特异度为77.4%）。
结论
双能谱CT有鉴别S-BAC和FOP的潜力。
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