双源CT碘含量定量分析肾脏占位病变的强化  

Dual-source CT iodine quantificative analysis of enhancing renal lesions

作　　者：李雪霜[1] 王贝贝[1] 何花[2] 郭玉林[2] 

机构地区：[1]宁夏医科大学临床医学院,宁夏银川750004 [2]宁夏医科大学总医院放射科,宁夏银川750004

出　　处：《中国医学影像技术》2016年第6期937-940,共4页Chinese Journal of Medical Imaging Technology

基　　金：2015宁夏研究生教育创新计划项目(NXYC201511)

摘　　要：目的比较双源CT碘含量测定与传统CT值测量判断肾脏占位病变强化的能力,探讨双源CT碘定量分析技术评价肾脏占位碘摄取的准确率。方法对63例怀疑肾脏占位病变患者行双源CT实质期双能量扫描,由2名影像医师分别用两种方法对图像进行分析。A法采用常规方法观察图像,计算病灶在平扫和加权融合图像CT值的差值,将CT值的变化幅度>20HU作为判断强化的标准。B法将数据调入Liver VNC后处理软件获得碘图,划定ROI,测得病灶的碘含量,将碘含量>0.5mg/ml作为双源CT碘含量定量分析判断强化的标准。以手术病理或综合影像随访为标准,运用χ2检验分别计算两种判断方法的准确率、敏感度、特异度、阳性预测值及阴性预测值。运用McNemar分析比较两种方法的准确率。结果传统CT值的测量和碘含量判断肾脏占位强化的准确率、敏感度、特异度、阳性预测值、阴性预测值分别为81.36%、74.42%、100%、100%、59.26%和98.31%、100%、93.75%、97.73%、100%。McNemar分析得出双源CT碘含量测定判断肾脏占位强化的准确率明显高于传统CT值测量(P<0.001)。结论双源CT碘含量定量分析可更为客观、快速、准确地评估肾脏占位病变碘摄取情况,既减少了患者的扫描时间及辐射剂量又提高了诊断的准确率,具有重要的临床意义。Objective To compare the diagnostic accuracy of iodine quantification and standard enhancement measurements in distinguishing enhancing from nonenhancing renal masses.Methods Sixty-three patients suspected renal masses underwent with dual-source CT nephrographic phase dual energy scan.All images were analyzed by two radiologists using two different methods,respectively.Method A observed the images through conventional approach,calculating the difference value between the CT value of plain scan and that of weighted imaging fusion,taking the variation of CT values20HU as a threshold to determine enhancement.Method B acquired iodine maps by inputting the data into Liver-VNC software,tested the iodine concentration of the lesion after specifying the ROI,and took iodine concentration0.5mg/ml as a threshold to determine enhancement in dual-source CT.Sensitivity,specificity,positive predictive value（PPV）and negative predictive value（NPV）of standard enhancement measurements and iodine quantification were calculated byχ2tests taking histopathology or imaging follow-up as the reference standard.Difference in accuracy was assessed by means of McNemar analysis.Results Sensitivity,specificity,PPV,NPV and diagnostic accuracy for standard enhancement measurements and iodine quantification were 81.36%,74.42%,100%,100%,59.26% and 98.31%,100%,93.75%,97.73%,100%,respectively.The McNemar analysis showed that the accuracy of iodine quantification was significantly better than that of standard enhancement measurements（P0.001）.Conclusion Compared with standard enhancement measurements,iodine quantification is more accurate in distinguishing enhancing from nonenhancing renal masses.

关 键 词：体层摄影术 X线计算机 肾脏占位病变 碘含量 

分 类 号：R737.11[医药卫生—肿瘤] R814.42[医药卫生—临床医学]