摘要
目的:基于能谱CT碘图测量碘值以评价肝脏泡球蚴内部碘值分布情况,结果与PET-CT检查的^(18)F-FDG suv值对照,评价能谱CT在评价肝脏泡球蚴活性方面的应用价值。方法:收集18例肝泡球蚴病患者,同期均行能谱CT双能量三期增强扫描及FDG-PET扫描,获得动脉期(arterial phase,AP),门脉期(portal venous phase,PVP)以及静脉期(venous phase,VP)的能谱CT双能量及PET-CT数据。利用AW4.6后处理工作站获得碘基图及最佳单能图像,分别测定病灶中心、病灶边缘区域、邻近肝实质及正常肝实质的碘值。采用秩和检验比较能谱CT双能增强扫描不同期相、不同组织间碘值差异,采用Sperarman法分析HAE病灶肝实质碘值、CT值,并与PET SUV值的相关性。结果:18例患者共发现18个病灶,18个病灶中经PET-CT证实有13个病灶为有活性的泡状棘球蚴病灶,占病灶总数的72.2%。门脉期及静脉期病灶边缘的碘浓聚程度明显高于病灶的实性成分及正常肝组织,PET-CT所显示的"热结节"在能谱CT上同样可显示为5~10mm厚的连续或不连续的环形强化。动脉期病灶实性成分、病灶边缘、邻近肝实质及正常肝实质的碘值分别为:7.97±1.95mg/ml,5.37±4.28mg/ml,8.26±4.48mg/ml,6.28±2.77mg/ml,门脉期病灶实性成分、病灶边缘、邻近肝实质及正常肝实质的碘值分别为:11.39±1.39mg/ml,13.40±4.70mg/ml,30.82±1.32mg/ml,26.16±1.43mg/ml,静脉期各组织碘值分别为:11.8±1.52mg/ml,12.29±3.76mg/ml,27.74±1.45mg/ml,24.16±1.44mg/ml,病灶实性成分各期碘值之间差异无统计学意义,病灶边缘区域、病灶邻近肝实质及正常肝实质的碘值之间的差异均有统计学意义(P<0.001)。三期病灶邻近肝实质CT值与SUV值无相关性;三期病灶邻近肝实质病灶边缘区碘值与suv值均存在相关性,其中门脉期碘值相关性最高(r=0.873,P<0.001)。结论:能谱CT碘图成像能通过评价泡球蚴内部碘值分布来评价病灶活性,其结果与PET-CT^(18)F-FDGSUV值高度相关,有望作为一种较为实用的常规技术推荐给临床应用。
Purpose： To assess the iodine concentration of hepatic alveolar echinococcosis （HAE） using spectral computed tomography （CT） with comparison of 18SF-FDG positron-emission tomography （FDG-PET）, and to explore the value of spectral CT for evaluation of HAE viability. Methods： Eighteen patients with histologically confirmed or clinically proved HAE underwent spectral CT and FDG-PET examinations. After three-phase [arterial phase scan, the raw data were transferred to ADW 4 （AP）, portal venous phase （PVP） and venos phase（VP）] 6 workstation. The quantitative iodine-based material decomposition images and optimal monochromatic images of spectral CT were reconstructed and iodine concentration （IC） was measured in different organizational structures （hydatid tissues, edge tissue of the lesion, marginal zone of the lesion and normal liver）. The Iodine value in different phases and different tissues were compared with rank test. The correlation of iodine value and PET SUV were analyzed with Spearman method. Results： FDG-PET identified increased metabolic activity in the corresponding lesions in 13 patients （13/18, 72.2%）. The iodine concentration in marginal zone of lesion were significantly higher than that in solid component of lesion and normal liver parenchyma during PVP and VP. Positive FDG-PET findings with ＂hot pot＂ were also positive at spectral CT images which displayed as continuous or discontinuous ring-like enhancement with 5-10mm thickness. （AP： 7.97± 1.95mg/ml, 5.37±4.28mg/ ml, 8.26±4.48mg/1, 6.28±2.77mg/ml; PVP： 11.39±1.39mg/m1, 13.40±4.70mg/ml, 30.82±1.32mg/ml, 26.16±1.43mg/ml; VP： 11.8± 1.52mg/ml, 12.29±.76mg/ml, 27.74±1.45mg/ml, 24.16±1.44mg/ml; both P 〈0.001）. The iodine value of hydatid tissues showed with no statistical significant difference （P〉0.05）. The iodine value of edge tissue of the lesion and normal liver, and iodine value of normal liver tissues were showed with statistical significant difference （P〈0.001）. There was correlation between IC and SUV in marginal zone of HAE lesion] and it was the highest during PVP （r = 0.873, P〈 0.001）. There was poor correlation between CT values and SUV. Conclusion： There was good correlation between spectral CT and FDG-PET. Spectral CT could be recommended as a more practical tool in the clinical routine.
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2015年第4期375-378,共4页
Chinese Computed Medical Imaging
基金
国家自然科学基金No.81260232~~
关键词
计算机断层摄影
碘图成像
FDG-PET
肝泡状棘球蚴
活性
Spectral imaging
Iodine-based material decomposition
FDG-PET
Hepatic alveolar echinococcosis, Activity
