Application Study Of Spectral Imaging In The Differentiation Of Solitary Pulmonary Nodule With Pathological Validation

ObjectiveTo discuss the evaluation of energy spectrum CT in rhe diagnosis of the solitary pulmonary nodule(SPN.using the standard iodine concentration,the effective atomic number,and the slope of the energy spectrum curve of 40-90 ke V Caomaration the different types and pathological classification of the solitary pulmonary tuberculosis in the above parameters.MethodsEighty-five patients with solitary pulmonary nodules from the September,2013 to December,2016(49 males;36 females.ages from 30-78 years old,with a mean of 46.7years old.)were given two-phase enhancement of the chest scan with Gemstone Spectral Imaging(GSI)with Gemstone Energy Spectrum CT.Among them,All the diagnoses were confirmed by surgical pathology or biopsy.Inflammatory nodules were found in 17 cases including inflammation,pulmonary abscess,pulmonary tuberculosis,25 cases of malignant nodules,including adenocarcinoma(19 cases),squamous cell carcinoma(24 cases).Imagings were analyzed from the standardized iodine concentration,the effective atomic number,and the slope of 40-90 ke V energy spectrum curve of SPN.All the data were analyzed by using SPSS statistical analysis software(version 17.0).T-test was used to compare the above datum among groups.ResultsThe normalized iodine concentration and the slope of 40-90 ke V energy spectrum curve were different for the inflammatory,pulmonary tuberculosis,and malignant pulmonary groups.The largest was the inflammatory group,and the malignant pulmonary nodule group was being the next while the tuberculosis was the smallest.But there was no statistically significant difference in the number of effective atomicnumbers among the three groups.There were significant differences in the standard iodine concentration between the inflammatory group and the tuberculosis group,the inflammatory group and the malignant pulmonary nodule group,the tuberculosis group and the malignant pulmonary nodule group and the slope of the 40-90 ke V energy spectrum.The normalized iodine concentration,the effective atomic number and the slope of the 40-90 ke V spectrum were significantly different in the lung adenocarcinoma group and the lung squamous cell carcinoma group.The mean of the iodine concentration and effective atomic number in lung adenocarcinoma group was larger than that in lung squamous cell carcinoma group ConclusionThe normalized iodine concentration and the slope of 40-90 ke V spectrum can be used as the index of differential diagnosis of inflammation,malignant pulmonary nodule and tuberculosis,which can be used as the identification of the differential diagnosis of lung adenocarcinoma and lung squamous cell carcinoma.The effective atomic number of arterial phase in CT imaging parameters is less effective in the identification of inflammation,malignant pulmonary nodules and pulmonary tuberculosis.But it can be used as an index for differential diagnosis of lung adenocarcinoma and lung squamous cell carcinoma Energy spectrum CT imaging can play a significant role as a new technology in the diagnosis of solitary pulmonary nodules.