双能CT平扫GSI综合分析对肝脓肿与肝转移瘤的鉴别诊断价值  

Comprehensive analysis of unenhanced dual-energy CT GSI in the differential diagnosis of abscess and metastases of liver

作　　者：王楠[1] 刘爱连[1] 陈安良[1] 刘晓冬[1] 陶奉明 赵莹[1] 徐明哲[1] WANG Nan;LIU Ai lian;CHEN An liang(the First Hospital Affiliated Dalian Medical University,Liaoning 116011,China)

机构地区：[1]大连医科大学附属第一医院,辽宁116011

出　　处：《放射学实践》2018年第7期704-707,共4页Radiologic Practice

摘　　要：目的:探讨双能CT平扫GSI综合分析对肝脓肿和肝转移瘤的鉴别诊断价值。方法:回顾性搜集2011年9月-2016年12月采用单源双能CT行GSI平扫的肝脓肿和肝转移瘤患者58例(共79个病灶),其中肝脓肿29个,转移瘤50个,均经临床随访或病理证实。所有入组病灶均见明显的中心液化区。在AW4.5工作站上,由两位医师(分别工作5年、3年)采用双盲法分别测量病灶中心液性成分不同单能量(40~140keV)的平扫CT值,脂-水浓度值、血-水浓度值和有效原子序数,两次测量数据行组内相关系数(ICC)检验,选择高年资医师所测数据行Mann-Whitney秩和检验。计算各病灶的能谱曲线斜率(K),将能谱曲线分为上升型(K>0.1),平坦型(-0.1≤K≤0.1)和下降型(K<0.1),比较肝脓肿和肝转移瘤的能谱曲线类型。结果:两位医师测量数据一致性良好(ICC均>0.9)。在40~110keV水平下,肝脓肿组与肝转移瘤组的单能量CT值差异均有统计学意义(P<0.05)。肝脓肿组和肝转移瘤组的血(水)浓度值、脂(水)浓度值、有效原子序数差异均有统计学意义(P<0.05);肝脓肿组能谱曲线类型平坦型为主(48.3%),肝转移瘤组能谱曲线类型下降型为主(50%),两组患者能谱曲线斜率差异有统计学意义(P<0.05)。结论:双能CT平扫GSI综合分析对肝脓肿和肝转移瘤的囊性成分鉴别具有一定的价值。Objective：To study the value of unenhanced dual-energy CT GSI in the differential diagnosis of abscess and metastases of liver.Methods：Unenhanced dual-energy CT GSI was performed,from September 2011 to Dec 2016,in 58 patients with 79 liver lesions proven by clinical followup or pathology（abscess,n=29;metastases,n=50）.All of these lesions recruited had obvious central liquefied area.The mean CT value of monochromatic（40-140 keV）,fat-water concentration and blood-water concentration of the lesions and effective atomic number（eff-Z）were measured on an AW 4.5 workstation by 2 radiologists with an experience as 5 y and 3 y double-blindly.ICC test was calculated and Mann-Whitney rank test was used for the data acquired by the senior radiologist.The slope of spectral curve（K）was measured and divide into 3 types：ascending type（K0.1）,straight and plain type（-0.1≤K≤0.1）and descending type（K0.1）,the type of spectral curve in the abscess group and metastases group were compared statistically.Results：The data measured by the 2 radiologists were in accordance（all ICC0.9）.As energy level ranging from 40 to 110 keV,the singleenergy CT value of liver metastases and abscess shown significant statistic difference（P〈0.05）.The blood-water concentration,the fat-water concentration and the eff-Z showed significant statistic difference between liver abscess and metastases（P〈0.05）.In the 29 liver abscesses,the spectral curve of metastases mainly showed as straight and plain type（48.3%）,while in the 50 liver metastases,they were mainly descending curves（50%）,with significant differences（P〈0.05）.Conclusion：Using unenhanced dual-energy CT GSI to analyze the liquefied component is helpful in the differential diagnosis of liver abscess and metastases.

关 键 词：肝肿瘤 肝脓肿 肝转移瘤 体层摄影术 X线计算机 诊断 鉴别 

分 类 号：R814.42[医药卫生—影像医学与核医学] R735.7[医药卫生—放射医学]