双能CT成像70 keV单能量图像在中央型肺癌支气管动脉成像中的应用研究  

Assessment of bronchial artery by using 70 keV monochromatic images of dual-energy computed tomography in central-type lung cancer

作　　者：李旸[1] 王海彦[1] 杨泽宏[2] 李冬雪 谢超 LI Yang;WANG Haiyan;YANG Zehong;LI Dongxue;Xie Chao(Department of Radiology, Jiangsu Cancer Hospital, Nanjing 210009, China;Department of Radiology, Sun Yat-Sen Memoiral Hospital, Sun Yat-Sen Univeristy, Guangzhou 510120, China)

机构地区：[1]江苏省肿瘤医院(江苏省肿瘤防治研究所,南京医科大学附属肿瘤医院)影像中心,江苏南京210009 [2]中山大学孙逸仙纪念医院放射科,广东广州510120

出　　处：《中国肿瘤外科杂志》2020年第3期211-214,共4页Chinese Journal of Surgical Oncology

摘　　要：目的探讨双能CT成像(DECT)70 keV单能量成像在评估中央型肺癌支气管动脉供血中的价值。方法选取江苏省肿瘤医院和中山大学孙逸仙纪念医院2017年6月至2019年5月收治的中央型肺癌患者114例。全部行胸部CT血管成像(CTA)检查,其中61例行能谱增强扫描,53例行普通增强扫描。能谱扫描组获取70 keV单能量图像及混合能量图像,普通扫描组获取120 kVp图像,采用多平面重组(MPR)、最大密度投影(MIP)与容积再现(VR)技术进行支气管动脉图像后处理;观察并比较三种图像对支气管动脉的开口、1~3级支气管动脉分支显示效果的差异。结果114例中央型肺癌患者行CTA检查均可观察到多支支气管动脉供血。70 keV单能量、混合能量及120 kVp CT图像对支气管动脉开口、1~2级支气管动脉分支的显示差异无统计学意义。在显示支气管3级分支上70 keV单能量CTA略优于混合能量(P=0.048),而70 keV单能量、混合能量均明显优于120 kVp CT图像(P<0.01)。结论DECT 70 keV单能量CTA能够全面评估中央型肺癌肿瘤供血支气管动脉开口及其分支走行,能为肿瘤血供评估及介入治疗提供有力支持。Objective To determine the value of 70 keV monochromatic images angiography of dual-energy computed tomography(DECT)in evaluating the feeding bronchial artery of central-type lung cancer.Methods 114 patients who have been pathologically diagnosed as central-type lung cancer from Oct.2017 to Apr.2019 in Jiangsu Cancer Hospital and Sun Yat-Sen Memorial Hospital were analyzed.All patients underwent CT angiography examination.61 patients received spectral enhancement scanning,and 53 patients performed conventional enhancement scanning.The bronchial artery was assessed by post-processing techniques with multiple plane reformation(MPR),maximum intensity projection(MIP)and volume rendering(VR)using 70 keV monochromatic images,hybrid energy images and 120 kVp images.The conspicuity of the opening t and 1-3 levels of feeding bronchial artery branch was compared by chi-square test.Results The feeding bronchial artery was observed in all of 114 patients with central-type lung cancer.Among 114 patients,there is no statistical difference to show the start and 1-2 levels of feeding bronchial artery branch showed in 70 keV monochromatic images,hybrid energy images and 120 kVp images.70 keV monochromatic images angiography showed bronchial level 3 branches slightly better than hybrid energy images(P=0.048),while the 70 keV monochromatic and hybrid energy images were obviously better than 120 kVp imges(P<0.01).Conclusions70 keV monochromatic images angiography of DECT could be used to assess the origin and morphology of bronchial artery supplying for central-type lung cancer,which has a certainly practical value for tumor blood supply assessment and interventional embolization treatment.

关 键 词：双能CT成像 中央型肺癌 支气管动脉 

分 类 号：R73[医药卫生—肿瘤]