2016 年第 8 期 第 14 卷

宝石能谱CT在胸膜原发肿瘤诊断中的价值初探

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关键词：体层摄影术,X线计算机能谱成像胸膜肿瘤

• 摘要：
• 【摘要】摘要[根据实际结果进行修改。] 目的 探讨宝石能谱CT在胸膜原发肿瘤术前诊断中的应用价值。方法:回顾性分析19例胸膜原发肿瘤的临床病理资料、CT图像特征和能谱参数，包括不同kev水平下的CT值，碘-水浓度及良恶性病变的能谱曲线斜率等，并进行统计学分析。结果 恶性病变8例:胸膜孤立性纤维性肿瘤(SFTP)3例，胸膜间皮瘤3例，滑膜肉瘤2例;良性病变11例:神经鞘瘤9例，SFTP1例，脂肪瘤1例。恶性与良性肿瘤（除外脂肪瘤）能谱参数比较，恶性肿瘤平均碘浓度及平均水浓度为（14.05±8.82）g/l、（1027.32±8.64），良性肿瘤平均碘浓度及平均水浓度为（6.38±5.33）g/l、（1016.44±11.94）；恶性肿瘤能谱曲线斜率为（1.40±0.70），良性肿瘤能谱曲线斜率为（0.85±0.54）；40-110kvp条件下恶性肿瘤CT值明显大于良性肿瘤，且具有统计学意义（P<0.05）。结论 不同病理类型的胸膜原发肿瘤具有一定的能谱CT特征，CT图像和能谱参数的结合对胸膜原发肿瘤良恶性的判断具有一定的价值。 关键词：体层摄影术,X线计算机；能谱成像；胸膜肿瘤
• Objective: To study the value of spectral CT in the preoperative diagnosis of primary pleural tumors. Materials and Methods: Nineteen patients with primary pleural tumors were enrolled. All were performed spectral CT with gemstone spectral imaging (GSI) technique. Clinicopathologic characteristics of each patients were documented. The measurement of CT values of each lesions on images in varying keV was obtained. The GSI parameters of iodine-water concentration and spectral curve slope were recorded. The differences of GSI parameters between the benign and malignant tumors were analyzed. Result: Malignant tumors were confirmed in 8 cases including solitary fibrous tumors of the pleura (SFTP) of 3, mesothelioma of 3 and synovial sarcoma of 2. Benign tumors were determined in 11 cases including schwannoma of 9, SFTP of 1, lipoma of 1. The measurement of average iodine and water concentration of malignant tumors were（14.05 ± 8.82g/l 、1027.32 ± 8.64），which of benign tumors were（6.38 ± 5.33g/l、1016.44 ± 11.94）. The curve slope of malignant tumors was（1.40 ± 0.70），and that of benign tumors was ( 0.85 ± 0.54). The average CT value of malignant tumors was significantly greater than that of benign tumors on the images obtained with 40-110 keV (P＜0.05). Conclusion: Primary pleural tumors in various etiologies have some characteristics on spectral CT. The combination of conventional CT imaging and spectral parameters is helplful to distinguish benign tumors from malignant tumors. Keywords: Tomography，X-ray computed ；Spectral imaging；Pleural tumors