能谱CT联合高场MR扩散加权成像对有胆道侵犯的肝泡型包虫病浸润评估研究  

Evaluation of infiltration degree of hepatic alveolar echinococcosis with biliary tract invasion by energy spectrum CT combined with high field MR diffusion weighted imaging

作　　者：杜嘉宁 孟莉[1] 刘林勋[2] 拜昕 文丽娟 曹梦琳 DU Jianing;MENG Li;LIU Linxun;BAI Xin;WEN Lijuan;CAO Menglin(Imaging Center,the Affiliated Hospital of Qinghai University,Xining 81000l,China;Department of General Surgery,Qinghai Provincial People's Hospital,Xining 81001,China)

机构地区：[1]青海大学附属医院影像中心,青海西宁810001 [2]青海省人民医院普外科,青海西宁810001

出　　处：《实用放射学杂志》2022年第9期1465-1468,共4页Journal of Practical Radiology

基　　金：青海省科技厅科技计划项目(2018-ZJ-758)。

摘　　要：目的探讨联合能谱CT多参数成像及高场MR扩散加权成像(DWI)对有胆道侵犯的肝泡型包虫病周围浸润程度影像学评价价值.方法选取诊断为肝泡型包虫病并术中证实具有胆道侵犯患者30例,均于术前行肝包虫动态增强能谱CT扫描及肝包虫MR扫描,分析影像图像中病灶基本特征,并分别取病灶内、边缘带、周围肝实质及远离病灶正常肝实质共4个感兴趣区(ROI)进行能谱CT后处理分析及表观扩散系数(ADC)测量;比较该4个部位碘值、能谱曲线斜率及ADC值差异性.结果(1)30例病例34个病灶,肝左胆管侵犯8个,肝右胆管侵犯21个,胆总管侵犯5个;肝右胆管受侵犯发生率相对较高.病灶最大径约(11.32±0.67)cm.(2)4个ROI的ADC值之间的差异有显著统计学意义(P<0.05),组间差异显示边缘带与其他3个ROI差异有显著统计学意义,其他3个ROI差异无统计学意义.(3)肝泡型包虫病病灶在动脉期及静脉期与其他3个部位碘值、能谱曲线斜率差异有统计学意义,边缘带、周围肝实质及远离病灶正常肝实质3个部位碘值、能谱曲线斜率比较差异无统计学意义.门静脉期边缘带及周围肝实质间碘值比较差异无统计学意义,余部位组间比较差异均有统计学意义.病灶内碘值、能谱曲线斜率在不同期相比较差异无统计学意义.结论能谱CT门静脉期碘值对有胆道侵犯的肝泡型包虫病周围浸润程度评估具有价值.Objective To explore the imaging estimate value of the energy spectrum CT multi-parameter imaging and high field MR diffusion weighted imaging(DWI)in the evaluation of the degree of surrounding invasion of hepatic alveolar echinococcosis with biliary tract invasion.Methods A total of 30 patients diagnosed with hepatic alveolar echinococcosis and confirmed with biliary tract invasion during operation were collected.All patients underwent liver hydatid dynamic enhanced energy spectrum CT and MR scanning preoperative.The basic characteristics of images in the image lesions were analyzed and pick up regions of interest(ROI)around the lesions,marginal zone,peripheral liver parenchyma and away from the focal normal liver parenchyma,energy spectrum CT postprocessing analysis and apparent diffusion coefficient(ADC)measurement were done in the four areas of interest;The iodine values,energy spectrum curve slope and ADC values of the four sites were compared.Results(1)In this study,there were 34 lesions in 30 cases,including 8 lesions in left hepatic bile duct,21 lesions in right hepatic bile duct,and 5 lesions in common bile duct.The incidence of invasion of the right hepatic bile duct was relatively high.The maximum diameter of the lesion was(11.32±0.67)cm.(2)There were statistically significant differences in ADC values among the four ROI(P<0.05).The inter-group differences showed that the marginal zone had statistically significant differences with the other three ROI,while the other three ROI showed no statistically significant differences.(3)There were statistically significant differences in iodine value and energy spectrum curve slope between hepatic alveolar echinococcosis lesions in arterial phase and venous phase and the other three parts,while there were no statistically significant differences in iodine value and energy spectrum curve slope in marginal zone,peripheral liver parenchyma and away from the focal normal live parenchyma.There was no statistically significant difference in iodine value between the m

关 键 词：肝泡型包虫病 胆道侵犯 计算机体层成像 磁共振成像 扩散加权成像 

分 类 号：R532.32[医药卫生—内科学] R575[医药卫生—临床医学] R814.42R445.2