【摘要】 目的 探讨能谱CT成像定量参数对IA期肺腺癌高级别模式(HGP)的评估价值,以期为临床制定干预治疗方案提供参考。方法 选取2020年1月至2024年6月IA期肺腺癌患者98例,根据手术病理检查结果分为HGP组与非HGP(non-HGP)组,术前均行能谱CT检查,比较两组能谱CT定量参数[动静脉期碘基值(IC)、标准化碘基值(NIC)、水基值(WC)、曲线斜率(K)、平均CT值],分析各参数对HGP的单独及联合评估价值。结果 HGP组动静脉期WC、K、平均CT值高于non-HGP组(P<0.05);动脉期WC、静脉期WC、动脉期K、静脉期K、平均CT值评估IA期肺腺癌HGP的AUC分别为0.798、0.759、0.731、0.749、0.784,敏感度分别为68.18%、72.73%、68.18%、63.64%、81.82%,特异度分别为88.16%、73.68%、75.00%、85.53%、73.68%;危险度分析显示,动脉期WC、静脉期WC、动脉期K、静脉期K、平均CT值高值提示IA期肺腺癌HGP的风险增加倍(P<0.05);动脉期WC、静脉期WC、动脉期K、静脉期K、平均CT值联合评估IA期肺腺癌HGP的AUC为0.903,敏感度为86.36%,特异度为89.4 7%,评估价值优于各参数单独评估价值(P<0.05)。结论 能谱CT成像定量参数可用于IA期肺腺癌HGP评估中,为临床早期鉴别IA期肺腺癌HGP、针对性制定干预治疗方案提供参考依据。更多还原

【Abstract】 Objective To explore the evaluation value of quantitative pa rameters of spectral CT imaging for highgrade pattern(HGP) of stage IA lung adenocarcinoma,with a view to providing reference for clinical intervention treatm ent planning.Methods A total of 98 patients with lung adenocarcinoma in the IA stage from January 2020 to June 2024 were selected and divided into the HGP group and the nonHGP group based on surgical pathology results.All patients underwent spectral CT examination before surgery.The quantitative pa ramete rs of spectral CT [arteriovenous iodine base value(IC),normalized iodine base value(NIC),water base value(WC),curve slope(K),average CT value] were compared in the two groups,and the individual and combined evaluation value of each parameter for HGP were analyzed.Rsults The WC, K,and average CT values in the arteriovenous phase of the HGP group were higher than those in the non-HGP group(P<0.05).The AUCs of WC in the arterial phase,WC in the venous phase,K in the arterial phase,K in the venous phase,and mean CT value for evaluating HGP in stage IA lung adenocarcinoma were 0.798,0.759,0.731,0.749,and 0.784,respectively.The sensitivities were 68.18%,72.73%,68.18%,63.64%,and 81.82%,respectively,and the specificities were 88.16%,73.68%,75.00%,85.53%,and 73.68%,respectively.The risk analysis showed that the high values of WC in the arterial phase,WC in the venous phase,K in the arterial phase,K in the venous phase,and average CT value were associated with an increased risk of HGP in stage IA lung adenocarcinoma(P<0.05).The combined assessment of WC in the arterial phase,WC in the venous phase,K in the arterial phase,K in the venous phase,and the average CT value for the evaluation of HGP in stage IA lung adenocarcinoma had an AUC of 0.903,with a sensitivity of 86.36% and a specificity of 89.47%.The evaluation value was superior to that of each parameter evaluated individually(P<0.05).Conclusion The quantitative parameters of spectral CT imaging can be used in the evaluation of HGP in stage IA lung adenocarcinoma,providing a reference for early clinical ide ntification of HGP in stage IA lung adenocarcinoma and targeted interve ntion treatment plans.更多还原