| Objectives Imaging differences of mediastinal lymph node metastasis and mediastinal sarcoidosis between mediastinal lymphoma and thymic cancer,small cell lung cancer(SCLC)by energy spectrum CT.Methods A total of 101 first-diagnosed patients with mediastinal nodules or masses found on CT plain scan in Tangshan People's Hospital from April 2018 to October 2019 were selected as study subjects.According to the pathological results after bronchoscopy or puncture,the patients included in the study were divided into thymic cancer group,mediastinal lymphoma group;SCLC mediastinal lymph node metastasis group(no exact primary focus in the lung)and mediastinal sarcoidosis group.Among them,19 cases were male and 9 cases were female in thymic cancer group,with an age of(52.52±9.84);clinical symptoms: chest pain,cough and asthma in 18 cases,limb weakness in 6 cases,and no obvious symptoms in 4 cases;12 cases were male and 10 cases were female in mediastinal lymphoma group,with an age of(51.43±10.16);clinical symptoms: cough,chest discomfort in 12 cases,superficial lymphadenopathy in 7 cases,and no obvious symptoms in 3 cases;SCLC mediastinum In the lymph node metastasis group,there were17 males and 8 females,with an age of(55.28±9.06).The clinical symptoms were chest pain or chest distress in 10,cough in 7,asthma in 5 and shortness of breath in 3.In the mediastinal sarcoidosis group,there were 15 males and 11 females,with an age of(55.8±9.47).The clinical symptoms were chest distress in 13,cough in 5,asthma in 6 and no obvious symptoms in 2.After the approval of the hospital ethics committee,the patient signed the informed consent and performed energy spectrum CT enhanced scanning.The energy spectrum parameters,such as 40-140 kev single energy CT value,slope of energy spectrum curve(k),iodine concentration(IC),water concentration(WC),were obtained by using the energy spectrum post-processing software.SPSS 20.0 was used for data collation and analysis.The values of each group were listed by counting data and X2 test was used;the measurement data were expressed by mean ± standard deviation,and the changes of CT value,iodine content and water content of the lesions in the two groups under different single energy levels were tested by independent sample t test.The difference was statistically significant with P<0.05 as the difference,and the diagnostic efficiency of energy spectrum CT was evaluated.Results 1 The single energy CT value of 40-80 ke V in arterial and venous phase in thymic cancer group was higher than that in mediastinal lymphoma group,the difference was statistically significant(P<0.05);There was no significant difference between 90-110 ke V single energy CT and mediastinal lymphoma(P>0.05).The single energy CT value of 40-80 kev segment in artery phase and 40-90 kev segment in vein phase in SCLC group with mediastinal lymph node metastasis was significantly higher than that in mediastinal sarcoidosis group(P<0.05);There was no significant difference between 80-140 kev single energy CT value in arterial phase and 90-140 kev single energy CT value in venous phase between the two groups(P>0.05).2 In thymic cancer group,the water concentration in arterial and venous phase was lower than that in mediastinal lymphoma group,and the iodine concentration was higher than that in mediastinal lymphoma group(P<0.05).The iodine concentration in arteriovenous phase in SCLC group with mediastinal lymph node metastasis was higher than that in mediastinal sarcoidosis group,the difference was statistically significant(P<0.05);There was no significant difference in water concentration between the two groups at the arteriovenous stage(P>0.05).3 The slope of energy spectrum curve of 40-80 ke V segment in arterial and venous phase in thymic cancer group was significantly higher than that in mediastinal lymphoma group,the difference was statistically significant(P<0.05).The slope of 40-70 kev,70-100 kev and 100-140 kev energy spectrum curve in the SCLC group with mediastinal lymph node metastasis was significantly higher than that in the mediastinal sarcoidosis group(P<0.05);There was no significant difference in the slope of these three energy spectrum curves between the two groups(P>0.05).Conclusions 1 The difference between mediastinal lymphoma and thymic cancer can be shown in the single energy CT value of 40-80 kev,the water concentration and iodine concentration of arterial phase and venous phase,which is helpful to distinguish them.2 The difference between SCLC mediastinal lymph node metastasis and mediastinal sarcoidosis can be demonstrated by energy spectrum scanning in arterial phase 40-80 Kev and venous phase 40-90 Kev single energy CT values,iodine concentration in arterial phase and venous phase and the slope of energy spectrum curve in venous phase,it has good application value.Figure 4;Table 7;Reference 161... |
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