The Application Value Of Energy Spectrum CT In Differentiating Benign And Malignant Pulmonary Nodules And Masses

Objective:By comparing the characteristic parameters generated,to explore the application value of energy spectrum CT enhanced scanning in evaluating the benign and malignant pulmonary nodules and masses,providing a new basis for the qualitative diagnosis of preoperative lesions.Methods:A total of 145 patients who underwent enhanced energy spectrum CT scanning were retrospectively analyzed.They were collected and divided into three groups（benign group,n=24;inflammatory group,n=35;malignant group,n=86）according to the pathological results,follow-up records,and clinical results.The CT values,iodine values（IC）,and water values（WC）at40,70 and 100ke V in arterial and venous phase of the three groups were measured respectively,and the normalized iodine concentration（NIC）,NIC difference（ΔNIC）and the slope of energy spectrum curve（K）were calculated.Then the differences of energy spectrum parameters and diagnostic efficiency among the three groups were compared and analyzed.Results:1.The difference of energy spectrum parameters（IC,NIC,ΔNIC,K）between the three groups in arterial phase and venous phase was statistically significant（P<0.05）.However,there was no significant difference in WC values between the three groups in arterial and venous phases（P>0.05）.2.Comparing the energy spectrum parameter values between the three groups in arterial and venous phases,the difference between groups B and I or between groups B and M was statistically significant（P^a<0.05）,while the difference between groups I and M was not statistically significant（P^a>0.05）.3.ΔNIC:There were significant differences between groups B and M,groups B and I（P^a<0.05）.There was no significant difference between groups I and M（P^a>0.05）.4.Comparing the values of each group by the box chart,the parameters of group B were lower than those of the other two groups.In the ROC curve,group B compared to group I,the diagnostic efficiency of K_40-70in the arterial phase was the highest（AUC=0.985）.When 1.355 was taken as the threshold,the sensitivity and specificity were 100%and 87.5%respectively.Compared with group M,the diagnostic efficiency of each energy spectrum parameters in the venous phase was higher than that in the arterial phase.Conclusions:Energy-Spectral CT imaging is a more promising method in differentiating benign and malignant pulmonary nodules and masses,especially in the venous phase of enhanced scan.