能谱CT虚拟平扫在肾癌中的应用  

The application of spectral CT virtual non-contrast imaging in diagnosing renal carcinoma

作　　者：马光明[1] 段海峰[1] 贺太平[1] 于勇[1] 杨创勃[1] 贾永军[1] 任成龙[1] 韩冬[1] 

机构地区：[1]陕西中医药大学附属医院影像科,陕西咸阳712000

出　　处：《实用放射学杂志》2017年第1期115-118,共4页Journal of Practical Radiology

摘　　要：目的 探讨能谱CT虚拟平扫（VNC）替代常规平扫在肾癌中的临床应用价值。方法 回顾分析32例经病理证实为肾癌的患者影像资料，均行能谱CT常规平扫及动脉期、静脉期能谱成像（GSI），采用MSI软件生成动脉期VNC和静脉期VNC图像。分别测量3组图像（常规平扫、动脉期VNC、静脉期VNC）肾脏病灶的CT值、病灶GAAB2正常肾脏的对比噪声比（CNR），同层面病灶的长径、橫径，采用单因素方差分析；由2位放射科医师对3组图像分别行5分制图像质量主观评分，3分制影像学征象主观评分，对2位医师评价结果的一致性行Kappa检验，对3组图像的图像质量主观评分行单因素方差分析。结果 2位医师对3组图像评价结果的一致性较好（Kappa值均＞0.700）；3组图像间图像质量主观评分无统计学差异（P＞0.05）；影像学征象主观评分动脉期VNC为2.88±0.34，静脉期VNC为2.84±0.37，均可接受。3组图像的CNR分别为0.52±0.11、0.72±0.16、0.69±0.12，动脉期VNC、静脉期VNC的对比噪声比（CNR）均高于常规平扫，有统计学差异（P＜0.05）。3组图像同层面病灶的长径和横径无统计学差异（P＞0.05）。3组图像肾脏病灶的CT值分别为（30.04±4.09） HU、（32.69±4.07） HU、（32.56±3.52） HU，有统计学差异（P＜0.05），常规平扫病灶的CT值低于动脉期VNC和静脉期VNC，但差值均在5 HU内。结论 在肾癌检查中VNC能替代常规平扫，可减少患者的扫描次数，降低辐射剂量。Objective To investigate the value of spectral CT virtual non-contrast （VNC} imaging replacing the conventional true non-contrast （TNC） imaging in diagnosing renal carcinoma.Methods 32 patients with renal carcinoma confirmed by pathology were analyzed retrospectively. All of the patients underwent the conventional plain scan, and contrast-enhanced scans at arterial phase （AP} and venous phase （VP） using spectral CT. VNC images at AP and VP were generated on AW4.6 using MSI software. CT number, contrast-to-noise ratio （CNR} of the lesions and normal kidneys, long and short axis diameters of the lesions were measured respectively from the three image sets and analyzed by one-way ANOVA. Two radiologists subjectively evaluated image quality using 5-point score, and lesion features using 3-point score. Their agreement with regard to the scores between two radiologists were assessed using Cohen＇s Kappa analysis, and the subjective image quality scores among the three image groups were compared with one-way ANOVA. Results The two radiologists had good agreement for the subjective image quality scores （Kappa〉0.700） with no significant differences among the 3 image groups （P〉0.05）. The lesion features scores were 2.88±0.34 for VNC （AID） and 2.84±0.37 for VNC （VP）, and the grade could be acceptable. The CNR values were 0.72 ± 0.16 in VNC （AP） and 0.69 ± 0.12 in VNC （VP）, and were significantly higher than that of 0.52±0.11 in TNC （P〈.05）.There were no significant differences for the lesion long and short axis diameters among the 3 image groups （P〉0.05）. The CT numbers of the renal lesions were （30.04±4.09} HU for TNC, （32.69±4.07） HU for VNC （AP） and {32.56±3.52） H U for VNC （VP）. There was statistical difference among the 3 image groups but the maximum differences between groups were less than 5 HU.Conclusiun VNC images can be used to replace the conventional plain scan to reduce scan time and radiation dose in diagnosing renal carcinoma.

关 键 词：计算机体层成像 虚拟平扫 肾癌 

分 类 号：R814.42[医药卫生—影像医学与核医学] R737.11[医药卫生—放射医学]