能谱CT多参数成像在肾上腺意外瘤诊断中的应用  

Application of energy spectrum CT multi-parameter imaging in the diagnosis of accidental adrenal tumors

作　　者：张丹卉 张亚斌 史展[1] ZHANG Danhui;ZHANG Yabin;SHI Zhan(Department of Imaging Center,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang)

机构地区：[1]河南科技大学第一附属医院影像中心,河南洛阳471000

出　　处：《医学影像学杂志》2025年第2期80-83,共4页Journal of Medical Imaging

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20210588)。

摘　　要：目的探讨能谱CT多参数成像在肾上腺意外瘤诊断中的应用。方法选取我院经病理检查证实的52例肾上腺意外瘤患者资料并分析,其中肾上腺皮质腺瘤(ACA)38例(ACA组),肾上腺节细胞神经瘤(AGN)14例(AGN组)。观察肾上腺意外瘤形态学表现,探讨ACA与AGN常规CT征象、各单能量CT值、动脉期有效原子序数、各配对基物质浓度,并运用受试者工作特征(ROC)曲线分析能谱CT各指标在肾上腺意外瘤中的诊断效能。结果ACA多呈圆形与类圆形,CT平扫多呈低密度;AGN多呈卵圆形与水滴状,CT平扫多呈等密度;ACA组的最大径平均值高于AGN组;CT平扫ACA组的CT值低于AGN组,CT扫描动脉期、门静脉期ACA组的CT值高于AGN组。动脉期40~80 KeV的各单能量CT值ACA组均高于AGN组。两组各单能量CT值、动脉期有效原子序数、各配对基物质浓度比较,差异均有统计学意义(P均<0.05)。结论能谱CT多参数成像动脉期40 KeV单能量CT值、有效原子序数、碘-水浓度、脂-碘浓度的定量分析对肾上腺意外瘤具有较高的鉴别诊断价值,可准确评估ACA与AGN,在临床中具有较高的应用价值。Objective To investigate the application of spectral CT multi-parameter imaging in the diagnosis of accidental adrenal tumor.Methods 52 patients with AAT confirmed by pathological examination in our hospital were selected and analyzed,including 38 cases of adrenal cortical adenoma(ACA group)and 14 cases of adrenal ganglioneuroma(AGN group).We observed the morphological manifestations of adrenal incidentaloma,explored the conventional CT signs of ACT and AGN,the single energy CT value,the effective atomic number in arterial phase,and the concentration of each paired base material.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of spectral CT indicators in AAT.Results ACA was mostly round and quasi round,and low-density on plain CT scan,AGN was mostly oval and water drop shaped,and CT scan showed isodensity.The average maximum diameter of ACA was higher than that of AGN.The plain CT value of ACA was lower than that of AGN,and the CT value of ACA in arterial phase and portal venous phase was higher than that of AGN.The single energy CT values of ACA at arterial phase of 40-80kev were higher than those of AGN.There were significant differences between adrenal cortical adenoma and adrenal ganglioneuroma in single energy CT value,effective atomic number in arterial phase,and concentration of paired base substance(P<0.05).Conclusion The quantitative analysis of 40keV single energy CT value,effective atomic sequence,iodine water concentration,lipid iodine concentration in arterial phase of spectral CT multiparameter imaging has high differential diagnostic value for AAT and can accurately evaluate ACA and AGN,which has high application value in clinic.

关 键 词：肾上腺意外瘤 肾上腺皮质腺瘤 肾上腺节细胞神经瘤 体层摄影术 X线计算机 

分 类 号：R736.6[医药卫生—肿瘤] R814.42[医药卫生—临床医学]