| Objective:The invasiveness of lung adenocarcinoma presenting as pure ground glass nodules were investigated by using revolution CT spectral multiparametric imaging with the aim of providing a reference for rational clinical treatment.Materials and Methods:A total of 63 patients with lung adenocarcinoma,including 15 cases of adenocarcinoma in situ,18 cases of minimally invasive adenocarcinoma,and 30 cases of invasive adenocarcinoma,were collected from January 2019 to February 2021 in the hospital,using Revolution CT for spectral plain and enhanced scans,after strict inclusion and exclusion criteria,and AIS or MIA cases were set as group A and IAC cases as group B.The sequences containing dual energy spectral data were selected and reconstructed in stnd mode,uploaded to the post-processing workstation,and post-processed with GSI Viewer software to quantify the slope of spectral curve in unenhanced phase,water content,slope of spectral curve of both arterial and venous phases,iodine concentration,normalized iodine concentration,and the CT numbers at40-140 ke V monochromatic images at 10 ke V intervals in venous phases were quantified.Two independent samples t-test was used to compare the differences of spectral CT parameters in groups A and B.Statistical significance was considered at P< 0.05,and ROC curve analysis was performed for parameters with statistical significance.Results:Among 63 patients with lung adenocarcinoma,aged 33-75 years,37 were male and 26 were female,41 had no history of smoking and 22 had or had a previous history of smoking.In the unenhanced phase,the slope of spectral curve(k)was greater in group A(0.72±0.39)than in group B(0.42±0.48),and the water concent(WC)was smaller in group A(377.45±82.04)than in group B(491.15±109.13),with statistically significant differences in slope(k)and WC.In the arterial phase,skope(k)were(2.08±0.37)and(1.95±0.46),WC were(357.33±71.15)and(461.91±77.78),IC were(19.69±4.63)and(18.01±5.61),and NIC were(0.19±0.06)and(0.20±0.05);In venous phase,slope(k)were(1.95±0.51),(1.76±0.48),WC were(369.84±69.58),(472.98±75.41),IC were(14.73±3.13),(15.15±3.71),NIC were(0.30±0.07),(0.31±0.10).WC was statistically significant in the arterial and venous phase in both groups A and B,but slope(k),IC and NIC were not statistically significant in the arterial and venous phase.The CT numbers at 40-140 ke V monochromatic images at10 ke V intervals in venous phases were smaller in group A than in group B.The monochromatic images(40-140 ke V)were statistically significant for each CT value.The area under the ROC curve analysis of each parameter of the statistically significant spectral CT showed that the largest AUC was 0.812 for the monochromatic CT number at 140 ke V in the venous phase,with 89.74% sensitivity,75.00% specificity and an optimal diagnostic threshold of-515 HU.Conclusions:The quantitative multiparametric index of spectral CT has certain clinical application in determining the invasiveness of lung adenocarcinoma presenting as pure ground glass nodules,the monochromatic CT number at 140 ke V in the venous phase is an effective method to determine the invasiveness of lung adenocarcinoma presenting as pure ground glass nodules and have moderate diagnostic efficacy. |
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