摘要
目的探讨能谱CT在鉴别肝脏单纯囊肿（HC）和肝脏单房囊性包虫（UHCE）的应用价值。方法回顾性分析39例肝脏单房囊性占位病变患者,其中HC 19例（HC组）,UHCE 20例（UHCE组）,行平扫和三期增强能谱CT扫描后获得40~140keV单能图像病灶的CT值、碘（水）浓度、水（碘）浓度、有效原子序数,测量正常肝组织和腹主动脉碘值,计算不同期相标准化碘浓度（NIC）和病灶与周围正常肝组织碘浓度比值（LNR）,对两组结果进行统计学分析,并进行ROC曲线分析。结果 HC 40~50keV平扫、动脉期及延迟期单能量CT值均低于UHCE（P均〈0.05）,平扫和增强三期HC的碘（水）浓度低于UHCE（P〈0.05）,平扫、动脉期及延迟期HC的有效原子序数低于UHCE（P〈0.05）;平扫和动脉期HC的NIC高于UHCE（P均〈0.05）;HC动脉期水（碘）浓度略低于UHCE（P〈0.05）;平扫40keV下鉴别HC和UHCE的敏感度（100%）和特异度最高（75%）。结论能谱CT成像的定量分析对HC和UHCE的鉴别诊断有一定价值。
Objective To investigate the value of spectral CT imaging in differential diagnosis of hepatic cyst（HC）and unilocular hepatic cystic echinococcosis（UHCE）.Methods Thirty-nine patients with 19 HC and 20 UHCE were enrolled.All the patients underwent plain CT and tri-phase enhanced CT with single-source dual-energy mode.Material decomposition images and monochromatic images（40—140keV）were reconstructed.The iodine concentration（IC）,water concentration（WC）and the effective-Z were measured for lesions,normal liver parenchyma and aorta in each phase.The normalized iodine concentration（NIC）and lesion-to-normal parenchyma iodine concentration ratio（LNR）were calculated.Statistical and ROC analysis were performed.Results The mean CT values of monochoromatic energy with 40 keV and 50 keV in HC were significantly lower than those in UHCE during the plain,arterial and venous phase.The IC during all scan phases and effective-Z values during plain,arterial and venous phase were significantly lower than those in UHCE（all P〈0.05）.The NIC of HC were significantly higher than that of UHCE during the plain,arterial phases（both P〈0.05）.The mean WC of HC during arterial phase were lower than that of UHCE（P〈0.05）.Identification of HC and UHCE in plain40 keV had highest sensitivity（100%）and specificity（75%）.Conclusion Quantitative analysis of spectral CT imaging has been a promising method for differential diagnosis of HC and UHCE.
出处
《中国医学影像技术》
CSCD
北大核心
2015年第9期1344-1348,共5页
Chinese Journal of Medical Imaging Technology
基金
自治区科技计划项目(201433106)
关键词
肝
包虫病
体层摄影术
X计算机
宝石能谱成像
Liver
Echinococcosis
Tomography
X-ray conputed
Gemstone spectral imaging
