| 杨晶晶,吴秀丽,张丽萍,黄宝生.能谱CT多参数成像判断支气管色素沉着纤维化合并活动性肺结核[J].中国医学影像技术,2025,41(9):1526~1530 |
| 能谱CT多参数成像判断支气管色素沉着纤维化合并活动性肺结核 |
| Spectral CT multi-parameter imaging for diagnosing bronchial anthracofibrosis complicated with active pulmonary tuberculosis |
| 投稿时间：2024-12-27 修订日期：2025-09-05 |
| DOI：10.13929/j.issn.1003-3289.2025.09.015 |
| 中文关键词: 支气管疾病|纤维化|结核,肺|体层摄影术,X线计算机 |
| 英文关键词:bronchial diseases|fibrosis|tuberculosis, pulmonary|tomography, X-ray computed |
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| 中文摘要: |
| 目的 观察能谱CT多参数成像判断支气管色素沉着纤维化(BAF)合并活动性肺结核的价值。方法 回顾性纳入77例BAF伴肺不张患者,根据住院期间是否接受抗结核治疗判断其合并活动性肺结核(A组,n＝26)与否(B组,n＝51);分析胸部能谱CT图像中有无活动性肺结核CT征象(树芽征或小叶中心结节),测量支气管阻塞处和隆嵴下淋巴结的平扫CT值,增强动、静脉期40 keV和70 keV单能量CT值,以及有效原子序数(Zeff)、碘浓度(IC)、钙浓度(CC)及羟基磷酸盐浓度(HAP),计算能谱线斜率(λ40-70 keV)并进行组间比较。绘制受试者工作特征(ROC)曲线,基于曲线下面积(AUC)评估各单一参数及其联合判断BAF合并活动性肺结核的效能。结果 A组活动性肺结核CT征象显示率高于B组(P=0.005)。A组支气管阻塞处平扫和增强静脉期CT值40 keV,以及λ40-70 keV、Zeff、IC、CC及HAP均低于B组(P均＜0.05)。基于能谱CT所示活动性肺结核CT征象判断BAF合并活动性肺结核的AUC为0.659,支气管阻塞处CT联合定量参数的AUC为0.769;联合CT征象与CT定量参数的AUC为0.825,高于CT所示活动性肺结核征象(P＜0.05)。结论 基于能谱CT多参数成像能有效诊断BAF合并活动性肺结核。 |
| 英文摘要: |
| Objective To explore the value of spectral CT multi-parameter imaging for diagnosing bronchial anthracofibrosis (BAF) complicated with active pulmonary tuberculosis. Methods Totally 77 patients with BAF complicated with atelectasis were retrospectively enrolled. According to undergoing anti-tuberculosis treatment or not during hospitalization, 26 patients complicated with active pulmonarg tuberculosis were divided into group A (n＝26), while 51 cases without active pulmonarg tuberculosis were divided into group B. Signs indicating active pulmonary tuberculosis (i.e. tree-in-bud sign or centrilobular nodules) on chest spectral CT images were analyzed. Non-enhanced CT (NECT) values, single-energy CT values at 40 keV (CT40 keV) and 70 keV (CT70 keV), as well as effective atomic number (Zeff), iodine concentration (IC), calcium concentration (CC) and hydroxyapatite concentration (HAP) in the arterial phase and venous phase of enhancement at the site of bronchial obstruction and in subcarinal lymph nodes were measured, the slope of spectral line (λ40-70 keV) was calculated and compared between groups. Receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was used to evaluate the efficacy of the above parameter alone and their combinations for diagnosing BAF complicated with active pulmonarg tuberculosis. Results The displaying rate of active pulmonary tuberculosis CT signs in group A was higher than that in group B (P=0.005). NECT values, enhanced venous phase CT40 keV, λ40—70 keV, as well as Zeff, IC, CC and HAP at the site of bronchial obstruction in group A were all lower than those in group B (all P＜0.05). The AUC of active pulmonary tuberculosis CT signs for assessing BAF complicated with active pulmonary tuberculosis was 0.659, of the combination of CT quantitative parameters at the site of bronchial obstruction was 0.769, while of the combination of CT signs and CT quantitative parameters was 0.825, higher than of active pulmonary tuberculosis CT signs alone (P＜0.05). Conclusion Spectral CT multi-parameter imaging could be used to effectively diagnose BAF complicated with active pulmonary tuberculosis. |
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