Differential diagnostic analysis of pulmonary nodules using dual energy CT multi parameter quantitative analysis com-bined with morphological features

ZHU Dan; ZHANG Lixin; JIAO Yingzhi; SU Xinmiao; YAN Jinzhu; ZHANG Yanhui

doi:10.20258/j.cnki.1006-9011.2025.08.013

Abstract：Objective To explore the differential diagnostic value of dual energy CT multi parameter quantitative analysis combined with morphological features for the properties of pulmonary nodules.Methods A retrospective analysis was con-ducted on the data of 98 patients with pulmonary nodules who underwent dual energy CT multi-parameter quantitative analysis combined with morphological sign diagnostic analysis.According to the biopsy results,the patients were divided into benign group(n=46)and malignant group(n=52).The dual-energy CT parameters and morphological signs of the two groups were com-pared.The differential diagnostic efficacy of the main parameters and morphological signs on the nature of pulmonary nodules was analyzed.Results There was no significant difference in the detection rate of bronchial signs between the two groups(P>0.05),while,the detection rate of lobulation sign,spicule sign,spinous process sign,vacuole sign,pleural indentation sign,and vascular bundle sign was higher in the malignant group than that in the benign group,and the difference was statistically sig-nificant(P<0.05).The IC,NIC,and Zeff in the venous and arterial phases of the malignant group were higher than those in the benign group(P<0.05).Receiver operating characteristic(ROC)curve was drawn,and the results showed that NIC in the ve-nous and arterial phases had certain efficacy in distinguishing the nature of pulmonary nodules,with an area under the curve(AUC)>0.70,indicating low diagnostic value.The results of puncture biopsy were used as the gold standard,the optimal thresh-old for diagnosing and distinguishing the nature of pulmonary nodules using the main dual energy CT parameters was obtained through ROC.The differential diagnosis results were obtained based on the threshold.The results showed that the sensitivity of the dual energy CT multi parameter quantitative analysis combined with morphological signs for distinguishing the nature of pul-monary nodules was higher than that of the two examinations alone,and the negative predictive value was higher than that of the dual energy CT(P<0.05).The consistency Kappa value between the combined differential diagnosis and the gold standard was the highest.Conclusion Dual energy CT multi-parameter quantitative analysis combined with morphological features can effec-tively differentiate and diagnose the nature of pulmonary nodules,which has certain application value.