光谱胸部CT在胆囊阴性结石患者诊断中的应用价值分析  

Diagnostic Value of Spectral Chest CT in Patients with Negative Gallbladder Stones

作　　者：陈秀端 唐劲松[1] 江锋[1] Chen Xiuduan(Department of Radiology,Physical Examination Center,The Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350001)

机构地区：[1]福建中医药大学附属第二人民医院体检中心放射科,福建福州350001

出　　处：《黑龙江医药》2023年第3期554-557,共4页Heilongjiang Medicine journal

基　　金：福建省中青年教师教育科研项目(项目编号:JAT210198)。

摘　　要：目的:探讨光谱胸部CT在胆囊阴性结石诊断中的应用价值。方法:回顾性分析2021年1月—2022年6月在我院健康管理中心健康体检中疑似胆囊阴性结石的100例患者资料。所有患者均行光谱胸部CT检查。以超声检查结果为标准,评估光谱胸部CT扫描诊断胆囊阴性结石的效能,比较胆囊阴性结石与邻近胆汁在单能量图像中的对比度,光谱曲线斜率及有效原子序数。结果:100例患者中胆囊阴性结石97例,胆囊息肉3例,以此结果为参考标准,光谱胸部CT诊断胆囊阴性结石的准确度为94.00%、敏感度为93.81%、特异性为100%,与超声检查诊断一致性较好(Kappa=0.818)。阴性结石与邻近胆汁在40~50keV和90~200keV单能量图像中的CT值有差异(P<0.05),其中CNR值在200keV下最大,对比度在40keV下最大。阴性结石在40keV表现为低密度,在200keV表现为稍高密度。阴性结石的光谱曲线呈弓形缓慢上升型,邻近胆汁的光谱曲线呈水平直线型或轻微下降型;且两者的曲线斜率和有效原子序数存在统计学差异(P<0.05)。结论:光谱胸部CT具有较好的胆囊阴性结石诊断效能,值得临床应用。Objective:To investigate the value of spectral chest CT in the diagnosis of negative gallbladder stones.Methods:Data of 100 patients with suspected negative gallbladder stones who underwent physical examination in the Health Management Center of the Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2021 to June 2022 were retrospectively analyzed.All patients underwent spectral chest CT examination.The diagnostic efficacy of spectral chest CT scan for negative gallbladder stones was evaluated based on the results of ultrasonic examination.The contrast,slope of spectral curve and effective atomic number of negative gallbladder stones and adjacent bile in single energy images were calculated.Results:Among the 100 patients,97 cases had negative gallbladder stones and 3 cases had gallbladder polyps.With this result as the reference standard,the accuracy,sensitivity and specificity of spectral chest CT in the diagnosis of negative gallbladder stones were 94.00%,93.81%and 100%,which were consistent with ultrasonography(Kappa=0.818).The CT values of negative calculi and adjacent bile in 40~50keV and 90~200keV single energy images were statistically different(P<0.05),and the CNR value was the highest at 200 keV and the contrast was the highest at 40keV.Negative stones show low density at 40 keV and slightly high density at 200keV.The spectral curve of negative calculi was arched up slowly,and the spectral curve of adjacent bile was horizontal straight or slightly down.The curve slope and effective atomic number were statistically different(P<0.05).Conclusion:Spectral chest CT has good diagnostic efficacy of negative gallbladder stones and is worthy of clinical application.

关 键 词：光谱胸部CT 胆囊阴性结石 应用价值 

分 类 号：R575.6[医药卫生—消化系统]