双层光谱CT 45 keV单能量图像在肝细胞肝癌TACE术后随访中的应用  

Application value of dual-layer spectral CT 45 keV single energy image in follow up after TACE for hepatocellular carcinoma

作　　者：蒋燕[1] 唐洁 付志浩 田玉亭 李代欣 谢正平 JIANG Yan;TANG Jie;FU Zhihao;TIAN Yuting;LI Daixin;XIE Zhengping(Department of Medical Imaging,the Second Hospital of Nanjing,Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing 210003,China)

机构地区：[1]南京中医药大学附属南京医院(南京市第二医院)医学影像科,江苏南京210003

出　　处：《实用放射学杂志》2024年第3期483-486,共4页Journal of Practical Radiology

摘　　要：目的探讨双层光谱CT(DLCT)45 keV单能量图像在肝细胞肝癌(HCC)患者经导管动脉化疗栓塞(TACE)术后随访中的应用价值.方法回顾性分析60例HCC患者TACE术后复查的DLCT扫描图像.分别测量45 keV能谱CT和120 kVp常规CT 2种成像方式中病灶感兴趣区(ROI)及周围正常肝实质的CT值、标准差(SD)值,计算病灶与周围正常肝实质的对比噪声比(CNR)并比较其差异.采用3分法对2种成像方式的图像质量进行主观评分,并依据病灶强化程度及肿瘤染色情况进行分组,绘制受试者工作特征(ROC)曲线.结果(1)客观评价:120 kVp常规CT动脉期、门脉期及延时期之间CNR差异无统计学意义(Hc=1.128,P>0.05);45 keV能谱CT的CNR高于120 kVp常规CT,差异有统计学意义(Z=5.060,P<0.05).(2)主观评价:45 keV能谱CT的主观评分高于120 kVp常规CT,差异有统计学意义(Z=5.335,P<0.05).ROC曲线分析显示,45 keV能谱CT较120 kVp常规CT有更大的曲线下面积(AUC),差异有统计学意义(Z=4.136,P<0.001).结论45 keV能谱CT图像能显著提高肿瘤活性灶与正常肝实质间的CNR,具有更优质的图像质量和更高的诊断效能.Objective To investigate the application value of dual-layer spectral computed tomography(DLCT)45 keV single energy image in follow up after transcatheter arterial chemoembolization(TACE)for hepatocellular carcinoma(HCC).Methods The DLCT images of 60 patients with HCC after TACE treatment were analyzed retrospectively.The CT value and standard deviation(SD)value of the lesion region of interest(ROI)and surrounding normal liver parenchyma on two kinds of images with 45 keV energy spectrum CT and 120 kVp conventional CT were measured respectively,then the contrast-to-noise ratio(CNR)between the lesions and surrounding normal liver parenchyma was calculated,and their differences were compared.The image quality of the two kinds of images was scored subjectively with the 3-point method,and the patients were divided into different groups according to the enhance-ment degree and tumor staining.The receiver operating characteristic(ROC)curve was also drawn.Results(1)There was no signif-icant difference in CNR between arterial phase,portal phase,and delayed phase of 120 kVp conventional CT(Hc=1.128,P>0.05).The CNR of 45 keV energy spectrum CT was higher than that of 120 kVp conventional CT,with a statistically significant difference(Z=5.060,P<0.05).(2)The subjective score of 45 keV energy spectrum CT was higher than that of 120 kVp conventional CT,and the difference was statistically significant(Z=5.335,P<0.05).ROC curve analysis showed that 45 keV energy spectrum CT had a larger area under the curve(AUC)than 120 kVp conventional CT,and the difference was statistically significant(Z=4.136,P<0.001).Conclusion 45 keV energy spectrum CT image can significantly improve the CNR between tumor and normal liver parenchyma,and it has the better image quality and higher diagnostic efficiency.

关 键 词：肝细胞肝癌 经导管动脉化疗栓塞 计算机体层成像 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学] R814.42