能谱CT物质分离技术克服肾囊肿伪强化的临床评估  

Clinical assessment of spectrum CT with material decomposition technique in overcoming renal cyst pseudoenhancement

作　　者：刘宏[1] 万泰虎[1] 王永亮[1] 赵卓[2] 柳林[1] 乔月[1] 张孟超[1] 

机构地区：[1]吉林大学中日联谊医院放射科,吉林长春130031 [2]吉林大学中日联谊医院手术室,吉林长春130031

出　　处：《中国医学影像技术》2017年第6期897-901,共5页Chinese Journal of Medical Imaging Technology

基　　金：吉林省科技发展计划项目(20160101074JC)

摘　　要：目的评估能谱CT物质分离技术克服肾囊肿伪强化的价值。方法 80例肾囊肿患者接受能谱GSI模式平扫及双期增强扫描,共入组75个囊肿,按囊肿大小分为3组,A组(n=25)肾囊肿直径0.5~<1.5cm、B组(n=25)直径1.5~<2.5cm、C组(n=25)直径2.5~<3.5cm。采用GSI Viewer分析软件生成碘、水基图,记录单能谱70keV图像上各期肾囊肿的CT值及碘水基值,比较各组肾囊肿平扫和增强双期CT值、碘水基值、CT值和碘水基值差值的差异。结果3组间实质期与平扫CT值差值总体差异有统计学意义(F=204.128,P<0.001),且两两比较差异均有统计学意义(P均<0.001)。增强后A、B组实质期CT值增加均超过10HU,出现了伪强化现象,C组CT值增加小于10HU,无伪强化现象。各组肾囊肿平扫、皮质期及实质期间碘基值差异有统计学意义(P均<0.001)。3组平扫和增强双期之间碘基值的差值均在10(100μg/cm^3)内,且差值平均值A组>B组>C组(P均<0.05)。A组肾囊肿皮质期及实质期水基值低于平扫(P均<0.05),但差值均在10mg/cm^3以内。结论能谱CT物质分离技术测定肾囊肿各期碘、水基值时同样会发生碘水基值的"漂移",肾囊肿越小其发生"漂移"的程度越大,碘基值发生漂移的程度受肾囊肿大小的影响较水基值更明显。Objective To evaluate the value of material decomposition imaging of spectrum CT in overcoming renal cyst pseudoenhancement. Methods Totally 80 patients with renal cysts （total 75 cysts） who underwent CT imaging with GSI mode were collected. The renal cysts were divided into 3 groups according to diameters, group A （diameters 0.5 -〈1.5 cm, n=25）, B （1.5 -〈2.5 cm, n=25） and C （2.5 -〈3.5 cm, n=25） respectively. The iodine-water density im aging was reconstructed by using the GSI Viewer analysis software. The CT value and iodine-water concentration of the cysts were recorded. The difference of CT value, iodine-water concentration in unenhanced and enhanced dual phases in each group was compared. Results The difference of CT value between plain scan and parenchyma phase among the 3 groups had statistically significant difference （F= 204. 128, P〈0. 001）, and the differences comparing any two were statis- tically significant （all P〈0.05）. The postcontrast attenuation increased more than 10 HU in group A and B, indicating re nal cyst pseudoenhancement, and less than 10 HU in group C, which had no pseudoenhancement. There were statistical difference in iodine concentration of the cysts of the 3 groups in unenhance, cortical and parenchyma phases （all P〈0. 001）, but the difference value in unenhanee, cortical and parenchyma phases were less than 10 （100 μg/cm3）, and the difference value of the 3 group was group ADgroup BDgroup C （all P〈0.05）. The water concentration of the cysts in group A descend in renal cortical and parenchyma phase with statistical difference （P〈0. 001）, hut the difference value was less than 10 mg/cma. Conclusion The measurements of iodine-water concentration appear to drift as well, the smaller the greater. The degree of the iodine concentration shifting is more obvious than water concentration.

关 键 词：体层摄影术 X线计算机 物质分离技术 肾囊肿 伪强化 

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