摘要
目的探讨CT能谱成像在鉴别诊断肝癌和血管平滑肌脂肪瘤中的价值。方法 33例肝脏占位病变患者,其中肝癌25例,血管平滑肌脂肪瘤8例,行宝石CT的能谱扫描模式(GSI)扫描,获得动脉期和门静脉期的能谱系列图像。测量病灶、正常肝组织和腹主动脉的能谱参数,并计算不同能量水平下病灶-肝脏对比噪声比(contrastto noise ratio,CNR),标准化碘浓度(normalized iodine concentration,NIC)和病灶与正常肝组织碘浓度比值(lesion-to-normal hepatic tissue ratio,LNR),对上述结果进行独立样本t检验。结果肝癌和血管平滑肌脂肪瘤的动脉期最佳单能量均为50 keV,门静脉期最佳单能量分别为70 keV、40 keV;动脉期最佳CNR分别为3.60±2.19、9.08±0.56,门静脉期最佳CNR分别为1.78±0.94、1.65±0.32;动脉期NIC分别为(0.26±0.09)mg/ml,(0.59±0.03)mg/ml,门静脉期NIC分别为(0.50±0.15)mg/ml,(0.78±0.03)mg/ml;动脉期LNR值分别为2.98±0.52,5.85±0.43,门静脉期LNR值分别为0.97±0.15,1.36±0.05。肝癌的动脉期和门静脉期NIC和LNR均低于血管平滑肌脂肪瘤。两者两期的NIC、LNR、钙(脂肪)浓度和脂肪(钙)浓度均有统计学差异(P<0.05),但其水(碘)浓度在两期中均无统计学差异(P>0.05)。结论 CT能谱成像的单能量图像、碘基图像和碘物质定量分析对肝癌和血管平滑肌脂肪瘤的检出和鉴别诊断有较大价值。
Objective To explore the application value of CT spectral imaging in the diagnosis of hepatocellular carcinoma and angiomyolipoma.Methods 33 patients with hepatic lesions received Gemstone Spectral Imaging scans,including 25 hepatocellular carcinomas and 8 angiomyolipomas,spectral serial images for the arterial phase and portal venous phase were obtained.The spectral parameters of lesions,normal hepatic tissue and the aorta were measured.The lesion liver contrast to noise ratio in the different energy levers,normalized iodine concentration and the lesion to normal hepatic tissue iodine concentration ratio were calculated.The results were analyzed with independent samples t test.Results The optimal monochromatic energy of hepatocellular carcinoma and angiomyolipoma were 50keV during the AP and 70keV and 40keV,during the PP respectively.The optimal CNR were 3.60± 2.19 and 9.08± 0.56,during the AP and 1.78±0.94,1.65±0.32,respectively,during the PP.The NIC were（0.26±0.09） mg/ml and（0.59±0.03） mg/ml,respectively,during the AP and（0.50±0.15） mg/ml and（0.78±0.03） mg/ml,respectively,during the PP.The LNR were 2.98±0.52 and 5.85±0.43,respectively,during the AP and 0.97±0.15 and 1.36±0.05,respectively,during the PP.The NIC and LNR for HCC were less than that of AML.There were significant differences in NIC,LNR,calcium（fat） and fat（calcium） concentration during the AP and PP between HCC and AML（P〈0.05）.There were no significant differences of HCC and AML in the water（iodine） concentration during the AP and PP（P〉0.05）.Conclusion Spectral CT with monochromatic images,iodine based material decomposition images and the quantitative analysis of iodine concentrations might be helpful for diagnosis of HCC and AML.
出处
《临床放射学杂志》
CSCD
北大核心
2012年第9期1274-1278,共5页
Journal of Clinical Radiology
基金
国家自然科学基金项目(编号:81071281)
上海市科委生物医药重点项目(编号:10JC1410900
10411953000)
关键词
能谱成像
单能量图像
碘基图像
血管平滑肌脂肪瘤
Spectral imaging
monochromatic imaging
iodine-based material decomposition image
angiomyolipoma
