乳腺癌颈胸腹盆增强CT:能谱与常规扫描模式比较  

Neck-chest-abdomen-pelvis Combined Enhanced CT in Breast Cancer Patients: Comparison between Dual-energy and Conventional Scanning Mode

作　　者：王宏[1] 李玲 逯瑶 于克祯 王国选 姜蕾[1] 李飒英[1] WANG Hong;LI Ling;LU Yao;YU Kezhen;WANG Guoxuan;JIANG Lei;LI Saying(Department of Radiology,Beijing Hospital,National Center of Gerontology,Institute of Geriatrics Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院放射科,国家老年医学中心/中国医学科学院老年医学研究院,北京100730

出　　处：《CT理论与应用研究（中英文）》2022年第4期489-498,共10页Computerized Tomography Theory and Applications

摘　　要：目的:通过与常规扫描方案比较,探讨能谱扫描方案在乳腺癌患者颈胸腹盆联合增强CT中的应用价值。方法:回顾性分析我院因乳腺癌行颈胸腹盆联合增强CT的女性患者40例,其中行常规颈胸腹盆增强CT患者20例,能谱颈胸腹盆增强CT患者20例。比较两种扫描方案动脉期和延迟期辐射剂量;通过测量颈胸部淋巴结的信号噪声比(SNR)及对比噪声比(CNR)以及主观评分,评价两种扫描方案的图像质量。结果:常规和能谱颈胸腹盆联合增强CT扫描方案的动脉期和延迟时期的辐射剂量具有统计学差异,能谱的辐射剂量更低;颈部动脉期淋巴结的SNR值、CNR值在常规和能谱扫描之间不存在统计学差异;胸部动脉期腋窝淋巴结的SNR值、CNR值在常规和能谱扫描之间存在统计学差异;颈部淋巴结常规和能谱扫描的主观评分不存在统计学差异,胸部腋窝淋巴结常规和能谱扫描的主观评分存在统计学差异,能谱主观评分更高,主观评分一致性较好,Kappa值为0.916。结论:能谱颈胸腹盆联合增强CT扫描方案的辐射剂量更低,扫描流程更简便,患者配合度更高,对于胸部腋窝淋巴结的显示更清晰,加之能谱扫描可以提供多参数的图像数据,因此具有重要的应用推广价值。Objective: To investigate the application value of dual-energy scanning scheme in neck-chest-abdomenpelvis combined enhanced CT in patients with breast cancer patients by comparing with the conventional scanning scheme. Methods: A retrospective analysis was performed on 40 female patients with breast cancer who underwent neck-chest-abdomen-pelvis combined enhanced CT in Beijing hospital, including 20 patients scanned by conventional protocol and 20 patients scanned by dual-energy protocol. The radiation doses in arterial phase and delayed phase were compared between the two modes. The image qualities were evaluated by measuring signal-tonoise ratio(SNR), contrast noise ratio(CNR) and subjective scoring. Results: The radiation doses in arterial phase and delayed phase of conventional and dual-energy protocol were statistically different, and the radiation dose of dual-energy protocol was lower. There was no significant difference between the two modes in SNR and CNR of cervical arterial lymph nodes. There was significant difference between conventional and dual-energy mode in SNR and CNR value of axillary lymph nodes in thoracic artery phase. There was no significant difference in the subjective scores of conventional and dual-energy protocol of cervical lymph nodes. However, there was significant difference in the subjective scores of conventional and dual-energy protocol of axillary lymph nodes.The subjective score of dual-energy protocol was higher and the consistency of subjective score was better with Kappa value of 0.916. Conclusion: Compared with conventional scanning scheme, dual-energy scanning scheme for neck-chest-abdomen-pelvis combined enhanced CT shows lower radiation dose, simpler scanning process,higher patient cooperation degree, clearer display of axillary lymph nodes, which has important clinical application and promotion value.

关 键 词：能谱CT 常规CT 颈胸腹盆增强CT 颈部淋巴结 

分 类 号：R816[医药卫生—放射医学] R322.27[医药卫生—临床医学]