Energy Spectrum CT Quantitative Analysis Application Solitary Pulmonary Nodule Diagnosis And Differential Diagnosis

Objective Gem spectrum quantitative CT analysis, study of different pathological types solitary pulmonary nodule(SPN) spectrum image characteristics, evaluation of spectral differential diagnostic value of CT in diagnosis and quantitative analysis of solitary pulmonary nodules, is isolated diagnosis of pulmonary nodules provide a quantitative basis, provide the basis for the clinical treatment options.Methods In our hospital CT scan spectrum gemstone solitary pulmonary nodules in patients with a total of 81 cases, the clinical and imaging data integrity, the patients were divided into 41 cases of malignant and benign group of 40 patients according to pathological type, in order to more detailed analysis of the energy spectrum parameters of different pathological types of differences, the group was divided into malignant adenocarcinoma group(29 cases) and squamous cell carcinoma(12 cases), benign inflammatory component group(17 cases), tuberculosis group( 14 cases) and benign group(9 cases). Use spectrum analysis software for image processing and analysis of data measurement and comparative analysis of the iodine content of each group of solitary pulmonary nodules, standardized iodine concentration, standardization of the difference between the iodine concentration, water content, standardized water concentration, water concentration difference of standardization single energy(40keV, 70 keV, 100 keV, 140 keV) CT value and the spectrum curve slope(40-70 keV, 70-100 keV, 100-140keV) differences. EDS analysis software with arterial and venous contrast to noise ratio of SPN best keV highest value when determining the best single energy image. Benign and malignant SPN compared with independent sample t test; adenocarcinoma, squamous cell carcinoma, inflammatory group and tuberculosis group, the benign group pairwise comparisons using ANOVA. Drawing receiver operating characteristic curve, and calculate the area under the curve, to obtain pulmonary nodules identify different properties of each quantitative parameters of the optimal threshold and the corresponding sensitivity and specificity.Results(1) Malignant solitary pulmonary nodules iodo parameters, different energy levels(40keV, 70 keV, 100 keV, 140 keV) CT value and 40-70 keV, 70-100 keV range spectrum slope were higher than benign group(P <0.05), the difference was statistically significant, and water-based parameters and 100-140 keV range spectrum curve slope was no significant difference(P> 0.05);(2) adenocarcinoma, squamous cell carcinoma, inflammatory group iodine-based parameters, different energy levels(40keV, 70 keV, 100 keV, 140 keV) CT value and 40-70 keV, 70-100 keV range spectrum slope were higher than tuberculosis group and benign group(P <0.05), the difference was statistically significant; among adenocarcinoma, squamous cell carcinoma, inflammatory and tuberculosis pairwise comparison group and benign group iodo parameters, different energy levels and each CT value range spectra curve slope differences were not statistically significant(P> 0.05); among five teams pairwise comparison of water-based parameters and spectrum slope 100-140 keV interval was not statistically significant(P> 0.05);(3) the energy spectrum parameters of intravenous iodine content in the SPN, the highest area under the ROC curve performance diagnostic value of 40 keV single energy CT diagnosis of benign and malignant pulmonary nodules were 0.779,0.749, when the diagnostic threshold selection 9.945,73.750, its diagnosis of malignant nodules sensitivity and specificity were 90.2 %, 65.0% and 95.1%, 62.5%;(4) adenocarcinoma, squamous cell carcinoma and tuberculosis group and benign group the highest diagnostic efficacy of standardized parameters intravenous iodine concentration(VP NIC), and inflammatory group tuberculosis group, benign group diagnostic efficacy parameter is the difference between the highest standardized iodine concentrations(ICD);(5) found that artery and vein of the best CNR keV highest value 40 keV, 65 keV, arterial phase constituent ratio 37%, 63%, venous phase proportions were 38%, 62%.Conclusion(1) Part iodo parameters, single-energy CT values exist between benign and malignant SPN and five teams slope difference spectroscopy to measure the energy spectrum parameters for the differential diagnosis of different pathological types of SPN important;(2) changes spectrum slope of the curve is consistent with the iodine concentration, are reflected in the material composition and internal blood supply, it can be used to identify lesions derived from different tissues and different pathological components of the same tissue source;(3) gem spectrum enhanced CT scan(4) spectroscopy parameters of intravenous iodine content of SPN, 40 keV single energy CT diagnostic value; as a noninvasive technique that can provide additional information for the identification and quantitative analysis of the nature of solitary pulmonary nodules pulmonary nodule benign and malignant diagnoses highest performance, can be applied to the vein of iodine content, 40 keV single energy CT value as a differential diagnosis of benign and malignant SPN standards. Adenocarcinoma, squamous cell carcinoma and tuberculosis group and benign group the highest diagnostic performance parameters VP NIC, and inflammatory group and tuberculosis group, the benign group the highest diagnostic performance parameters ICD, in future studies, You can use VP NIC, ICD as a differential diagnosis of different pathological types SPN standards;(5) the energy spectrum CT can be drawn from the best of its CNR keV highest value, the present study suggests that the image quality 65 keV mono-energetic image the best, after clinical work can take advantage of the best single image keV energy value of the nature solitary pulmonary nodules were analyzed.