DECT虚拟平扫在鉴别良恶性甲状腺结节的临床应用价值  

Clinical App Lication of Diagnosis and Differential Diagnosis of Benign and Malignant Thyroid Nodules with Dual Energy CT VNC

作　　者：刘力[1] 金梅[1] 高振兴[1] 林奕军 陈通[1] 侯庆更[1] 徐桂荣[1] 于晓明[1] 

机构地区：[1]齐齐哈尔市第一医院CT诊断中心,黑龙江161005

出　　处：《临床放射学杂志》2017年第4期571-576,共6页Journal of Clinical Radiology

基　　金：齐齐哈尔市科技局社会发展指导性计划项目(编号:SFZD-2014080)

摘　　要：目的探讨双源CT虚拟平扫(VNC)技术在甲状腺结节鉴别诊断中的应用价值。方法回顾性分析经病理证实并行甲状腺常规平扫(CNC)及双能量模式(DECT)增强扫描的58例甲状腺结节患者的影像资料,利用"Liver VNC""Monoenergytic"软件处理得到VNC图像、碘图及能谱曲线,对甲状腺结节VNC图像和CNC图像在平均CT值、信噪比(SNR)的图像质量、对比度噪声比(CNR)以及病灶的显示情况等方面进行比较研究。结果CNC和VNC所测甲状腺结节的平均CT值、SNR、CNR及图像质量,差异无统计学意义(P>0.05);双能量扫描模式较常规扫描模式的总辐射剂量小(P<0.05);双能CT检查的敏感性为88.5%,特异性为92.9%,准确性为96.2%。结论在甲状腺结节检查中,一次双能量增强扫描可获得增强图像和VNC图像、碘图和能谱曲线,而VNC图像不影响病灶的观察同时显著降低了辐射剂量,为甲状腺疾病临床诊疗提供新的影像学检查方法。Objective To investigate the clinical application of diagnosis and differential diagnosis of Thyroid Nodules with dual source CT virtual noncontrast（VNC）.Methods The radiographic data of fifty-eight cases with pathological diagnosis were retrospectively analyzed in parallel normal Thyroid conventional noncontrast（CNC） and Dual energy patterns（DECT） of patients with Thyroid nodule enhancement scanning,using the VNC iodine map and energy spectrum curve which was processed by the Liver VNC and Monoenergetic spectrum.We compared the Thyroid nodules VNC iodine map and energy spectrum curve image and CNC with the mean CT value image quality of signal to noise ratio（SNR）,contrast to noise ratio（CNR） as well as the display of the lesions,etc.Results The mean CT value,SNR,CNR and image quality of thyroid nodule measured by CNC and VNC had no statistically significant difference（P〉0.05）.The total radiation dose of the dual energy scanning mode is less than that of the conventional scan mode（P〈0.05）.The sensitivity of dual energy CT examination was 85.5%,specificity was 92.9% and the accuracy was 96.2%.Conclusion IIn the examination of thyroid nodules,enhanced image and VNC image and iodine map and energy spectrum curve can be obained by a dual energy enhanced scan.VNC image does not only have no effect on the lesion,but significantly reduces the radiation dose.The accuracy of qualitative diagnosis of thyroid nodules improved by quantitative analysis technique obviously has provided important information for clinical therapy of thyroid gland.

关 键 词：双能CT 虚拟平扫 甲状腺结节 辐射剂量 

分 类 号：R581[医药卫生—内分泌] R736.1[医药卫生—内科学] R730.44[医药卫生—临床医学]