Application Value Of Dual-Layer Detector Spectral CT In Differential Diagnosis Of Benign And Malignant Pleural Effusion

ObjectiveTo explore the application value of IQON spectral CT in differential diagnosis of benign and malignant pleural effusion when qualitative CT findings of pleura and its surrounding changes are combined with quantitative spectral parameters of pleural effusion.MethodsA total of 105 patients with pleural effusion Who underwent plain and contrast-enhanced scanning of chest with IQON spectral CT were analyzed and compared retrospectively,and the nature of the pleural effusions were confirmed by pathology and(or)clinical date.The qualitative CT findings consist of diffuse pleural thickening,pleural nodule,gravity-dependent distribution of fluid,unilateral or bilateral distribution,coarse extrapleural fat space and enlarged mediastinal lymph node with heterogeneous enhancement;Quantitative parameters included CT attenuation value of pleural effusion in conventional CT(120KVP),40 ke V and 70 ke V virtual single energy imagings,effective atomic number of pleural effusion and iodine concentration in no-water iodine imagings.Firstly,univariate analysis was performed,then those factors with statistically significant differences(p<0.05)were included in the binary Logistic regression for multivariate analysis.Results:Multivariate analysis showed statistically significant differences in the iodine concentration,pleural nodule and enlarged mediastinal lymph node with heterogeneous enhancement,which could be used as independent predictors of malignant pleural effusion.By combining these factors,one could obtain sensitivity of 86.8% and specificity of 84.6% with area-undercurve of 0.925[95%CI,(0.873-0.977)] for differentiating benign from malignant effusion.Conclusion:IQON spectral CT examination could well differentiate benign from malignant effusion when qualitative CT findings are combined with quantitative spectral parameters of pleural effusion.The possibility of the malignant pleural effusion will be considered When the patient with pleural effusion shows pleural nodule,enlarged mediastinal lymph node with heterogeneous enhancement and iodine concentration ofthe pleural effusion over 0.145mg/ml.