能谱CT成像多参数在肾上腺结节性增生与肾上腺皮质腺瘤鉴别诊断中的价值研究  

Study on the value of multi parameters of CT imaging of energy spectrum in the differential diagnosis of nodular hyperplasia of adrenal gland and the adenoma of adrenal cortex

作　　者：傅兰兰 胡晓丹 边玲 王聪 郝光军[3] FU Lan-lan;HU Xiao-dan;BIAN Ling(Department of Radiology,Liaoyang City Central Hospital,Liaoyang 111000,China;不详)

机构地区：[1]辽阳市中心医院放射线科,辽宁辽阳111000 [2]沈阳市第四人民医院放射科,辽宁沈阳110031 [3]榆林市第一医院肿瘤科,陕西榆林719000

出　　处：《中国医学装备》2023年第1期55-59,共5页China Medical Equipment

基　　金：辽宁省科学技术计划(20170720007)“肾上腺皮质结节性增生与皮质腺瘤的CT鉴别诊断”。

摘　　要：目的:分析能谱CT成像多参数在肾上腺结节性增生与肾上腺皮质腺瘤鉴别诊断中的价值。方法:选取医院收治的80例肾上腺疾病患者,根据病理结果,将肾上腺结节性增生患者纳入观察组(40例),肾上腺皮质腺瘤患者纳入对照组(40例),所有患者均行CT扫描,收集两组患者CT动脉期肾上腺能谱参数,包括40~140 keV的各单能量CT值、有效原子序数和各配对基物质浓度,绘制肾上腺结节性增生和肾上腺皮质腺瘤的受试者工作特征(ROC)曲线分析能谱参数对肾上腺结节性增生的诊断效能。结果:常规CT显示两组病灶形态均为类圆形结节状,其中观察组病灶与周围腺体分界不清,未见薄膜。对照组病灶最大径显著高于观察组,差异有统计学意义(t=7.901,P<0.05),而CT扫描动脉期CT值明显高于观察组,差异具有统计学意义(t=4.592,P<0.05)。观察组动脉期40 keV、50 keV、60 keV、70 keV及80 keV的各单能量CT值明显小于对照组,差异具有统计学意义(t=6.461,t=6.542,t=7.010,t=6.773,t=5.223;P<0.05)。两组动脉期有效原子序数、钙-水浓度、碘-羟基磷酸钙(HAP)浓度、碘-水浓度、HAP-水浓度、水-钙浓度、水-HAP浓度、脂-碘浓度及碘-脂浓度比较,差异具有统计学意义(t=9.236,t=6.670,t=2.931,t=6.231,t=6.416,t=2.716,t=4.355,t=6.655,t=2.666;P<0.05)。ROC曲线分析显示,40 keV单能量CT值、有效原子序数、碘-水及脂-碘浓度鉴别诊断肾上腺结节性增生和肾上腺皮质腺瘤的ROC曲线下面积(AUC)较高,分别为0.884、0.825、0.828和0.827。结论:能谱CT成像动脉期部分单能量图像及各配对基物质浓度对于鉴别肾上腺结节性增生具有一定的鉴别诊断价值,尤其40 keV单能量CT值、有效原子序数和碘-水及脂-碘浓度,可作为发现和诊断肾上腺结节性增生疾病的有效检查方法。Objective: To analyze the value of multi parameters of computed tomography(CT) imaging of energy spectrum in differential diagnosis of nodular hyperplasia of adrenal gland and the adenoma of adrenal cortex. Methods:80 patients with the disease of adrenal gland were selected, and 40 patients with the nodular hyperplasia of adrenal gland were divided into observation group and other 40 patients with the adenoma of adrenal cortex were divided into control group according to the pathological results. The parameters of energy spectrum of adrenal gland of two groups at arterial phase were collected, which included the CT value of each single energy between 40-140 keV, the effective atomic number and the material concentration of each paired substances. In addition, the receiver operating characteristics(ROC) curves of the nodular hyperplasia of adrenal gland and the adenoma of adrenal cortex were drawn respectively so as to analyze the diagnostic efficiency of the parameters of energy spectrum for nodular hyperplasia of adrenal gland.Results: Conventional CT showed that the morphologies of lesions of two groups were quasi-circular nodositas. Among of them, the dividing line between lesion and peripheral gland was ambiguous in observation group, and there was not thin film. The maximum diameter of the lesions in control group was significantly higher than that in observation group,with a statistically significant difference(t=7.901, P<0.05). The CT value of CT scanning in arterial phase of control group was significantly higher than that of observation group(t=4.592, P<0.05). The CT values of each single energy of 40-80 keV in arterial phase of observation group were significantly lower than those of control group, with statistically significant differences(t=6.461, t=6.542, t=7.010, t=6.773, t=5.223, P<0.05), respectively. There were significant differences in effective atomic number, calcium-water concentration, iodine-hydroxyapatite(HAP) concentration, iodinewater concentration, HAP-water concentration, water-calcium

关 键 词：能谱CT成像 肾上腺结节性增生 肾上腺皮质腺瘤 鉴别诊断 

分 类 号：R816.6[医药卫生—放射医学]