多模融合影像评估慢性再生障碍性贫血雄激素治疗肝脏占位病灶的价值  

Value of multi-modality medical image fusion technology in evaluating hepatic focal lesions in chronic aplastic anemia patients administered androgens

作　　者：马华林 隗功华 张哲 MA Hua-lin;KUI Gong-hua;ZHANG Zhe(CT/MR Room,Langfang TCM Hospital,Langfang Hebei 065000,China)

机构地区：[1]河北省廊坊市中医医院CT/MR室,河北廊坊065000

出　　处：《临床和实验医学杂志》2020年第22期2456-2459,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省廊坊市科技支撑计划项目(编号:2016013038);河北省科技攻关基金资助项目(编号:324410084)。

摘　　要：目的研究多模融合影像评估慢性再生障碍性贫血(CAA)雄激素治疗肝脏占位病灶的价值。方法前瞻性将廊坊市中医医院于2018年5月至2020年5月间,经B超检查提示肝占位的雄激素治疗77例CAA患者纳为研究对象,要求患者先后行多期螺旋增强CT扫描、实时双期C臂锥形束CT(DPCBCT)检查,并在控制室将DPCBCT动脉期与门静脉期图像与螺旋增强CT双期图像进行融合,对融合后动脉期及静脉期肝占位病灶的多模图像并排显示,评估多模融合影像在提示CAA雄激素治疗肝占位中的应用价值。结果77例考虑肝占位病变的CAA治疗患者中,经手术病理或穿刺病理证实肝占位者共63例,其余14例经临床及影像随访>6个月证实。其中肝恶性病变13例,均为肝细胞癌,肝良性病变64例;多期螺旋增强CT动脉期检出肝占位病变198个,门静脉期检出病灶203个,DPCBCT动脉期检出肝占位病变203个,门静脉期检出病灶217个;融合图像动脉期检出肝占位病变210个,门静脉期检出病灶223个。多期螺旋增强CT在诊断CAA肝占位中的灵敏度、特异度及准确度分别为92.31%、95.31%与94.81%;DPCBCT在诊断CAA肝占位中的灵敏度、特异度及准确度分别为69.23%、93.75%和89.61%;多模融合影像在诊断CAA肝占位中的灵敏度、特异度及准确度分别为100.00%、98.44%和98.70%。结论多模融合影像能有效提高雄激素治疗CAA患者肝占位病灶检出效果及病灶性质的判别,利于患者后期病情随访,可为肝占位治疗提供指导。Objective To investigate the value of multi-modality medical image fusion technology in evaluating hepatic focal lesions in chronic aplastic anemia(CAA)patients administered androgens.Methods Seventy-seven CAA patients administered androgens with hepatic focal lesions indicated by B-ultrasound in Langfang TCM Hospital from May 2018 to May 2020 were enrolled,and received multi-phase spiral enhanced CT scan,and real-time C-arm dual-phase cone beam CT(DPCBCT)examinations,respectively.The arterial phase and portal venous phase images of DPCBCT were fused with biphasic spiral enhanced CT images respectively.The hepatic focal lesion was evaluated alongside for each fused phase.Then the value of multi-modality medical image fusion technology in evaluating hepatic focal lesions in CAA patients administered androgens was analyzed.Results Among 77 patients,63 cases were confirmed by surgical pathology or puncture pathology,and the remaining 14 cases were confirmed by clinical and imaging follow-up>6 months.Among them,there were 13 cases of malignant liver lesions,all of which were hepatocellular carcinoma,and 64 cases of benign liver lesions.A total of 198 arterial and 203 portal venous lesions were detected by spiral enhanced CT;DPCBCT showed 203 arterial and 217 portal venous lesions,while multi-modality medical image fusion technology revealed 210 arterial and 223 portal venous lesions.The sensitivity,specificity and accuracy of spiral enhanced CT in diagnosis of hepatic focal lesions in CAA were 92.31%,95.31% and 94.81%,respectively.The sensitivity,specificity and accuracy of DPCBCT in diagnosis of hepatic focal lesions in CAA were 69.23%,93.75% and 89.61%,respectively.The sensitivity,specificity and accuracy of multi-modality medical image fusion technology in diagnosis of hepatic focal lesions in CAA were 100.00%,98.44% and 98.70%,respectively.Conclusion Application of multi-modality medical image fusion technology can effectively improve the diagnostic and identification rates of hepatic focal lesions in CAA patient

关 键 词：多模融合影像 慢性再生障碍性贫血 雄激素治疗 肝占位病变 

分 类 号：R575[医药卫生—消化系统]