宝石能谱CT单能量成像对乏血供肝脏小转移瘤的应用价值  

The value of monochromatic reconstruction of gemstone spectral CT in the evaluation of hypovascular small metastases of liver

作　　者：古丽米拉·巴巴什 周永[1] 文智[1] 张忠双[3] GULIMILA·Babashi;ZHOU Yong;WEN Zhi;ZHANG Zhongshuang(CT Room,the Tumor Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China;Department of Radiology,Xinjiang Changji People's Hospital,Changji 831100,China;Department of Basic Medical Sciences,Medical College of Shihezi University,Shihezi 832000,China)

机构地区：[1]新疆医科大学附属肿瘤医院CT室,新疆乌鲁木齐830011 [2]新疆昌吉州人民医院影像科,新疆昌吉831100 [3]石河子大学医学院基础医学系,新疆石河子832000

出　　处：《实用放射学杂志》2020年第12期1952-1956,共5页Journal of Practical Radiology

基　　金：新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目基金资助项目(WJWY-201965);新疆医科大学创新基金项目(XYDCX201668)。

摘　　要：目的探讨宝石能谱CT单能量成像(MR)改善图像质量及对乏血供肝转移瘤的应用价值.方法选取肝转移瘤患者46例,共116个乏血供病灶.使用能谱扫描模式(GSI)扫描,重建门脉期11组MR和混合能量成像(PR),根据肝转移瘤相对肝实质的对比度(C)和CNR,11组MR中选择最佳MR,其客观指标及主观评分与PR比较,由2名高年资医生独立判读最佳MR和PR,按照5分信度法记录各个病灶.配对χ^(2)检验分析P R与最佳MR阳性符合率差异,使用t检验比较P R与最佳MR结果一致组与不一致组的病灶直径、CNR等定量指标.结果60 keV单能量成像(MR60)客观指标、主观评分、检出率高于PR(P<0.05),直径<10 mm病灶中差异显著(P<0.05).结论MR60相比PR提高了图像质量和乏血供肝转移瘤的检出率,对小病灶(<10 mm)的检出更有价值.Objective To explore the value of monochromatic reconstruction(MR)of germstone spectral CT to improve the image.quality and in application with hypovascular metastases of liver.Methods 46 patients with hepatic metastases were collected,including 116 hypovascular lesions.C remstone spectral imaging(GSI)scanning was used to reconstruct 11 groups of MR and polychromatic reconstruction(PR)images during portal phase.According to the contrast of liver metastases to liver parenchyma(C)and CNR,the best MR was selected among 11 groups,and its objective indicators and subjective score were compared with PR.2 senior doctors interpreted the best MR and PR in this study independently and each lesion was recorded according to the 5-point reliability method.Paired chi-square test was used to analyze the difference of positive coincidence rate between PR and the best MR.The t-test was used to compare quantitative indexes such as lesion diameter and CNR in groups with consistent and inconsistent results between PR and the best MR.Results The objective index,subjective score,and detection rate of 60 keV monochromatic reconstruction(MR60)were higher than PR(P<0.05),and the difference was statistically significant in lesions with a diameter less than 10 mm(P<0.05).Conclusion Compared with PR,MR60 improves the image quality and the detection rate of hypovascular hepatic metastases,which is more valuable for the detection of small lesions(<10 mm).

关 键 词：肝脏 乏血供转移瘤 计算机体层成像 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]