能谱CT鉴别直径≤3cm肝硬化结节和小肝癌  

Spectral CT imaging in differential of cirrhotic nodule from small hepatocellular carcinoma with diameter≤3 cm

作　　者：吕沙沙 郑静 牛忠锋[2] Lü Shasha;ZHENG Jing;NIU Zhongfeng(Department of Radiology,Shaoring Central Hospital,Shaoxing,Zhejiang Province 312000,China;Department of Radiology,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310020,China)

机构地区：[1]绍兴市中心医院放射科,浙江绍兴312000 [2]浙江大学医学院附属邵逸夫医院放射科,浙江杭州310020

出　　处：《实用放射学杂志》2023年第7期1119-1122,共4页Journal of Practical Radiology

摘　　要：目的 探讨能谱CT鉴别肝脏原发直径≤3 cm肝硬化结节和小肝癌的价值.方法 回顾性选取影像及临床资料完整且经手术或穿刺病理确诊直径≤3 cm的肝硬化结节患者16例,小肝癌患者23例;分析临床及影像学资料,比较2组患者间年龄、病灶直径、肿瘤标记物[甲胎蛋白(AFP)、CA125、CA199、癌胚抗原(CEA)]水平,获得增强3期扫描病灶能谱曲线,计算病灶能谱曲线斜率、标准化碘浓度(NIC),采用独立样本t检验进行差异分析.结果 2组病灶能谱曲线斜率在动脉期低keV(40~80 keV)下有差异.动脉期肝硬化结节组能谱曲线斜率低于小肝癌组(1.15±0.47 vs 1.82±0.27),而在门脉期时肝硬化结节组能谱曲线斜率高于小肝癌组(1.87±0.24 vs 1.25±0.17),延迟期肝硬化结节组能谱曲线斜率略高于小肝癌组(0.82±0.36 vs 0.69±0.04),三者均有统计学差异(P<0.05).动脉期小肝癌组的NIC高于肝硬化结节组(0.20±0.03 vs 0.11±0.05);门脉期肝硬化结节组的NIC高于小肝癌组(0.57±0.09 vs 0.54±0.07);延迟期肝硬化结节组的NIC明显高于小肝癌组(0.44±0.02 vs 0.08±0.07),3期比较均有统计学差异(P<0.05).结论 能谱CT曲线斜率和NIC有助于在术前鉴别直径≤3 cm肝硬化结节和小肝癌.Objective To explore the value of spectral CT in differentiating cirrhotic nodule from small hepatocellular carcinoma with diameter≤3 cm.Methods A total of 16 patients with cirrhotic nodules and 23 patients with small hepatocellular carcinoma were retrospectively collected with complete imaging and clinical data and diagnosed by surgery or biopsy,and the diameter of the lesions was≤3 cm.The clinical and imaging data were analyzed,and the age,lesion diameter and the levels of tumor markers[alpha-fetoprotein(AFP),CA125,CA199,and carcinoembryonic antigen(CEA)]were compared between the two groups,and the energy spectrum curve of the lesions in the enhanced tri-phasic scan was obtained,and the slope of the energy spectrum curve and the normalized iodine concentration(NIC)of the lesions were calculated and the independent sample t test was used for difference analysis.Results The slopes of the energy spectrum curves of the two groups were different at low keV(40-80 keV)in the arterial phase.The slope of energy spectrum curve of the cirrhotic nodule group was lower than that of the small hepatocellular carcinoma group(1.15±0.47 vs 1.82±0.27)in arterial phase,higher(1.87±0.24 vs 1.25±0.17)in portal venous phase,and slightly higher in the delayed phase(0.82±0.36 vs 0.69±0.04),all with statistical differences(P<0.05).The NIC of the cirrhotic nodule group was lower than that of the small hepatocellular carcinoma group(0.11±0.05 vs 0.20±0.03)in the arterial phase,higher(0.57±0.09 vs 0.54±0.07)in the portal venous phase,and significantly higher(0.44±0.02 vs 0.08±0.07)in the delayed phase,and there were statistical differences among the three phases(P<0.05).Conclusion The slope of the spectral CT curve and the energy NIC are helpful for preoperative differentiating of cirrhotic nodule from small hepatocellular carcinoma with diameter of≤3 cm.

关 键 词：肝硬化结节 小肝癌 计算机体层成像 

分 类 号：R575.2[医药卫生—消化系统] R735.7[医药卫生—内科学] R814.42[医药卫生—临床医学]