Application And Research Of Revolution CT Energy Spectrum Imaging In The Diagnosis Of Patients With Pulmonary Nodule

Objective:The value of Revolution CT in the differential diagnosis of inflammatory and malignant pulmonary nodules and the pathological classification of lung cancer was determined by GSI plain and dual-phase?arterial phase and venous phase?enhanced scanning ofpulmonary nodules and multi-parameter quantitative analysis of energy spectrum using data post-processing software.In the meantime,we aim to further explore the value of Revolution CT in low-dose scanning through comparing the radiation dose of GSI plain and dual-phase enhanced lung scanning with that of conventional plain and dual-phase enhanced lung scanning.Methods:1.From March 2018 to September 2018,a total of 86 cases of pulmonary nodules eligible for inclusion in the first affiliated hospital of Bengbu medical college were subjected to the quantitative analysis of energy spectrum in terms of lung GSI plain and dual-phase?arterial phase and venous phase?enhanced scanning by Revolution CT.Using the AW4.7 workstation for data post-processing of energy spectrum to get the plain scan Effective atomic number?the Effective-Z?,the spectral curve of plain scan and dual-phase enhanced scan,and calculate the spectral curve slope(K=(|CT_40keV-CT_100keV|)/60),40keV CT values of arterial and venous phase,and the net increased CT values of 40keV(?CT=CT _{enhanced scan}-CT _{plain scan}),the normalized iodine concentrations?NIC=IC lesion/IC lesion with the level of the aorta or subclavian artery?of arterial and venous phase,and the net increased iodine concentrations(?IC=IC _{enhanced scan}-IC _{plain scan})of arterial and venous phase.SPSS23.0 software was used for statistical analysis of the above parameters of inflammatory nodules and malignant nodules,adenocarcinoma and squamous cell carcinoma.The quantitative data were in the form of mean±standard deviation.The statistical method was t test of two independent samples.P<0.05 was considered statistically significant.2.At the same time,60 patients who underwent lung GSI plain scan and dual-phase scan and 60 patients who underwent lung conventional CT plain scan and dual-phase enhanced scan were selected for dose length product?DLP?and effective dose?ED=the chest conversion factor of adult 0.014×DLP?statistics.The selected patients were all adults with body mass index of 20-25kg/m².SPSS23.0 software was used to conduct statistical analysis on DLP and ED of lung GSI plain scan and dual-phase enhanced scan,as well as conventional plain scan and dual-phase enhanced scan.The method was t test of two independent samples,and P<0.05 was considered statistically significant.Results:1.For the inflammatory nodules,the plain scan Eff-Z was 8.18±0.22;the K values of plain scan,arterial phase and venous phase were 1.12±0.44,2.69±0.61 and 2.74±0.59,respectively.CT_40keV of arterial phase and venous phase were 202.44±40.87 and202.48±37.29,respectively;?CT_40keV of arterial phase and venous phase were 110.55±33.11,111.00±27.13,respectively;NIC of arterial phase and venous phase were0.25±0.06 and 0.59±0.12,respectively;?IC of arterial phase and venous phase were13.69±4.06,13.63±3.26,respectively.For the malignant nodules,the plain scan Eff-Z was 7.92±0.15;the K values of plain scan,arterial phase and venous phase were0.63±0.26,1.57±0.38 and 1.75±0.36,respectively.CT_40keV of arterial phase and venous phase were 131.59±21.97 and 145.16±23.80,respectively;?CT_40keV of arterial phase and venous phase were 64.44±19.61,76.70±22.00,respectively;NIC of arterial phase and venous phase were 0.14±0.04 and 0.37±0.09,respectively;?IC of arterial phase and venous phase were 8.15±2.50,9.42±2.74,respectively.Inflammatory nodules were higher than malignant nodules in the above parameters,and the differences were statistically significant?P<0.05?.2.For the adenocarcinoma cases,the plain scan Eff-Z was 7.97±0.14;the K values of plain scan,arterial phase and venous phase were 0.70±0.25,1.71±0.38 and 1.98±0.31,respectively.CT_40keV of arterial phase and venous phase were 141.97±18.86 and159.02±21.13,respectively;?CT_40keV of arterial phase and venous phase were70.51±16.72,84.64±21.61,respectively;NIC of arterial phase and venous phase were0.15±0.04 and 0.42±0.07,respectively;?IC of arterial phase and venous phase were8.97±2.23,10.53±2.78,respectively.For the squamous cell carcinoma cases,the plain scan Eff-Z was 7.84±0.10;the K values of plain scan,arterial phase and venous phase were 0.48±0.18,1.37±0.32 and 1.49±0.26,respectively.CT_40keV of arterial phase and venous phase were 119.23±18.70 and 130.45±17.82,respectively;?CT_40keV of arterial phase and venous phase were 59.57±20.90 and 70.70±21.20,respectively;NIC of arterial phase and venous phase were 0.12±0.03 and 0.34±0.06,respectively;?IC of arterial phase and venous phase were 7.52±2.66 and 8.51±2.54,respectively.The above parameters of adenocarcinoma were higher than that of squamous cell carcinoma,and the differences were statistically significant?P<0.05?.3.For the patients with lung GSI plain scan and dual-phase enhanced scan,DLP and ED were 580.00±44.51 and 8.12±0.62,respectively.For the patients with lung conventional CT plain scan and dual-phase enhanced scan,the DLP and ED values were1125.31±177.28 and 15.78±2.50,respectively.The above parameters of patients with GSI scan were lower than those of the patients with conventional CT scan,and the difference was statistically significant?P<0.05?.Conclusion:Revolution CT energy spectrum imaging combined with its multi-parameter quantitative analysis has high diagnostic value for the differential diagnosis of pulmonary inflammatory nodules and malignant nodules as well as the pathological classification of lung cancer.In addition,the lung GSI plain scan and dual-phase enhanced scan can significantly reduce the radiation dose compared with conventional CT plain scan and dual-phase enhanced scan.