The Research Value Of The Energy Spectrum CT In The Diagnosis And Differential Diagnosis Of Pulmonary Mucinous And Nonmucinous Adenocarcinoma

Purpose: To analyze the application value of the energy spectrum CT in the diagnosis and differential diagnosis of pulmonary mucinous and nonmucinous adenocarcinoma.Methods: Collected the mucinous adenocarcinoma and nonmucinous adenocarcinoma,including mucinous adenocarcin To analyze the application value of the energy spectrum CT in the diagnosis and differential diagnosis of pulmonary mucinous and nonmucinous adenocarcinoma.oma in 12 cases,24 cases of nonmucinous adenocarcinoma,which were confirmed by surgery and pathology from January 2011 to December 2015 in our hospital.All patients received preoperatively the energy spectrum CT scan.The spectral parameters of the lesions,including40 ke V~140ke V different CT values of the ke V,energy spectrum curve slope,the effective-Z in the plain CT,plain and enhanced concentration of the material(iodine and water),were measured and analyzed by using the AW4.5 GE workstation postprocessing Gernerl GSI software.ROC curves were drawn with statistical significance to evaluate the diagnostic efficacy.Analyzed the imaging features of the lesion location,size,shape,solid components,edge,internal features,enhanced mode of mucinous adenocarcinoma and non mucinous adenocarcinoma and evaluated the application value of quantitative analysis of the energy spectrum CT in the diagnosis and differential diagnosis of pulmonary mucinous and nonmucinous adenocarcinoma with the CT imaging findings.Results:(1)There was significant difference in Mucinous and non mucinous adenocarcinoma of the location,the internal characteristics(vacuole sign),and enhanced mode(P<0.05).Mucinous and non mucinous adenocarcinoma frequently occur in the lower lobe of the lung and the upper lobe of the lung.Vacuole sign is more common in mucinous adenocarcinoma.Compared with the mucinous adenocarcinoma,the nonmucinous adenocarcinoma was significantly enhanced.(2)In the 40 ~ 60 ke V of plain and the 50 ~ 100 ke V of arterial phase were significantly different in the mucinous and non mucinous adenocarcinoma.There was a significant difference in the CT value of the venous phase and the delay period between 40 and 140 ke V(P<0.01).The slope of the energy spectrum curve of the lung mucinous adenocarcinoma in plain and enhancemenet were 0.69±0.49?1.28±0.66?1.21±0.75 ? 1.11±0.57;The slope of the energy spectrum curve of the lung nonmucinous adenocarcinoma in plain and enhancemenet were 0.34±0.23?1.43±0.65?1.59±0.54?1.47±0.45,there was a significant difference between the two groups in plain scan,venous phase and delayed phase(P<0.01),and there was no significant difference in arterial phase(P>0.05).(3)The effective-Z of the plain scanning of mucinous and non mucinous adenocarcinoma were 8.21±0.39 ? 7.87±0.18,and the difference was statistically significant(P<0.05).(4)The iodine concentration in the plain and enhanced phase of mucinous adenocarcinoma were 9.99±6.26g/L ?17.03±8.21g/L?14.10±7.10 g/L?13.10±6.47g/L,respectively.The iodine concentration in the plain and enhanced phase of nonmucinous adenocarcinoma were 9.99±6.26g/L ?17.03±8.21g/L?14.10±7.10 g/L?13.10±6.47 g/L,respectively.There was no significant difference between the two groups in the arterial phase(P>0.05),and there was a statistical significance in the plain,venous phase and delayed period.(P<0.05).The water concentration of mucinous and nonmucinous adenocarcinoma in the plain and enhanced phase were no statistically significant.(5)The diagnostic efficacy in the plain of effective-Z and the enhanced iodine concentration was similar,respectively,the AUC were 0.773,0.787,0.785,0.777.The diagnostic efficacy of CT values of arterial phase in 50 ke V,60 ke V,and 70 ke V was similar,the AUC were 0.859?0.879?0.844,respectively.The diagnostic efficacy of CT values of venous phase in 40 ke Vand,60 ke V was similar,both of the AUC were0.777.The diagnostic efficacy of CT values of delayed period in70 ke V?80ke Vand90 ke V was similar,the AUC were 0.869?0.864?0.866,respectively.Conclusion:Analysis to 40 ke V~140ke V different CT values of the ke V,energy spectrum curve slope,the effective-Z in the plain CT,plain and enhanced concentration of the iodine,and combining with the image manifestations can make qualitative diagnosis and differential diagnosis of mucinous and non mucinous adenocarcinoma.