Zhang Xirong MMed, Presenter: Nothing to Disclose

Jia Yongjun MMed, Abstract Co-Author: Nothing to Disclose

Yang Chuangbo MMed, Abstract Co-Author: Nothing to Disclose

Ma Chunling MMed, Abstract Co-Author: Nothing to Disclose

Lu Shuanhong MMed, Abstract Co-Author: Nothing to Disclose

To investigate the value of spectral CT in the differential diagnosis of benign pleural effusion and malignant pleural effusion.

14 patients with benign pleural effusion(8 with pneumonia,5 with pulmonary tuberculosis and 1 with pneumocystosis) and 15 patients with malignant pleural effusion(5 with adenocarcinoma of lung,4 with squamous cell carcinoma of lung,2 with adenosquamous carcinoma of lung and 4 with transitivity carcinoma of lung) underwent non-contrast spectral CT imaging. These patients were later verified by pathology. Various parameters for the effusion were measured: CT numbers of the polychromatic 140kVp, monochromatic images at 40keV and 100keV; the material contents on the water-, fat- and blood-based material decomposition images, and the effective atomic number Z. These values from the benign and malignant pleural effusion were statistically compared with t test.

The CT values of benign and malignant pleural effusion from the conventional 140kVp images showed no difference (12.61±3.39 vs. 14.71±5.03, p=0.20). The water-density, fat-density and blood-density between benign pleural effusion and malignant pleural effusion also did not show difference (P=0.18, 0.39,0.43, respectively). On the other hand, CT values of the benign pleural effusion and malignant pleural effusion at both the monochromatic 40keV and 100keV spectral images were statistically different: 43.15±3.79 vs. 39.42±2.60 at 40keV (p=0.005) and 9.11±1.38 vs. 6.52±2.04 at 100keV (p<0.001).The effective atomic number values of benign pleural effusion was 7.87±0.08,statistically different from that of the malignant pleural effusion (7.90±0.02)(P<0.05).

The spectral CT provides CT number measurements at both high and low energy levels and effective atomic number from a single scan to assist the differential diagnosis of benign pleural effusion from malignant pleural effusion.

 CT numbers at different energy levels from Spectral CT may be used to better differentiate benign pleural effusion from malignant pleural effusion.

Xirong, Z, Yongjun, J, Chuangbo, Y, Chunling, M, Shuanhong, L, Differential Diagnosis of Benign and Malignant Pleural Effusion with Spectral CT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14012269.html