摘要
目的探讨双源CT双能量成像技术在颈部鳞癌转移淋巴结与淋巴结结核鉴别诊断中的价值。资料与方法选取经病理证实为颈部鳞癌转移淋巴结、淋巴结结核的25例患者,共62枚颈部肿大淋巴结,均行双能量动脉期增强扫描。测量两种不同病理性质淋巴结实质碘覆盖值,观察能谱曲线变化趋势并比较两种不同病理性质淋巴结能谱曲线斜率,分析碘覆盖值和能谱曲线的斜率鉴别两种病变的诊断敏感度和特异度。结果 62枚淋巴结中,鳞癌转移性淋巴结32枚,淋巴结结核30枚。鳞癌转移淋巴结的碘覆盖平均值、曲线平均斜率与淋巴结结核比较,差异有统计学意义（t=3.806、3.698,P〈0.05）。在60-180 keV范围内,随着单能keV值的升高,鳞癌转移淋巴结与淋巴结结核CT值逐渐递减,且ke V值越高,CT值降低的幅度越小,其能谱曲线在60-180 keV下均呈下降型。碘覆盖值曲线下面积为0.756,对鉴别两种病变的诊断敏感度为56%,特异度为80%;能谱曲线的斜率曲线下面积为0.898,对鉴别两种病变的诊断敏感度为76%,特异度为85%。结论动脉期碘覆盖值及能谱曲线斜率对颈部鳞癌转移淋巴结与淋巴结结核的影像鉴别诊断均有一定的意义,且能谱曲线斜率对其鉴别诊断优于碘覆盖值。
PurposeTo explore the significance of dual energy CT in differential diagnosis of squamous cell carcinoma metastatic lymph nodes and lymph node tuberculosis in the neck.Material and Methods Twenty-five patients with a total of 62 cervical enlarged lymph nodes confirmed with squamous cell carcinoma metastasis or lymph node tuberculosis by pathology underwent dual energy enhanced CT scan. Iodine coverage value of two different kinds of pathological properties of lymph nodes was measured. The trend of the spectrum curve was observed and the energy spectrum curve slope of two kinds of lymph nodes were compared. The sensitivity, specificity and accuracy of energy spectrum curve slope in differential diagnosis were analyzed. Results Of all 62 lymph nodes, there were 32 squamous cell carcinoma metastatic lymph nodes and 30 lymph node tuberculosis. There were statistic significance in the iodine coverage between the squamous cell carcinoma metastatic lymph nodes and lymph node tuberculosis （t=3.806 and 3.698,P〈0.05）. In the range from 60 keV to 180 keV, CT value of the two kinds of lymph nodes decreased with increase of keV value. It showed the higher the keV value the less CT value decreased, with the energy spectrum curve of ＂drop type＂. The area of the iodine coverage was 0.756 with the differential diagnostic sensitivity of 56% and the specificity of 80%. The area of energy spectrum curve slope was 0.898 with the differential diagnostic sensitivity of 76% and the specificity of 85%.Conclusion The iodine coverage value and the energy spectrum curve slope have significance in differential diagnosis of the cervical squamous cell carcinoma metastatic lymph nodes and lymph node tuberculosis. The energy spectrum curve slope is superior to the iodine coverage value in differential diagnosis.
出处
《中国医学影像学杂志》
CSCD
北大核心
2015年第3期161-164,共4页
Chinese Journal of Medical Imaging
基金
云南省卫生科技计划项目(2014NS158)
关键词
头颈部肿瘤
癌
鳞状细胞
肿瘤转移
淋巴结
结核
淋巴结
体层摄影术
螺旋计算机
碘
诊断
鉴别
Head and neck neoplasms
Carcinoma,squamous cell
Neoplasm metastasis
Lymph nodes
Tuberculosis,lymph node
Tomography,spiral computed
Iodine
Diagnosis,differential
