双源CT对肾上腺少脂肪型腺瘤和转移瘤的鉴别诊断价值

发布时间：2018-03-01 02:21

本文关键词： 体层摄影术 X线计算机能谱成像肾上腺腺瘤转移瘤诊断　出处：《中国全科医学》2015年11期 　论文类型：期刊论文

【摘要】：目的探讨双源CT对肾上腺少脂肪型腺瘤和转移瘤的鉴别诊断价值。方法 2011年5月—2012年12月于河北医科大学第四医院就诊的50例肾上腺结节患者均使用双源CT对病灶进行平扫。测定融合图像中病灶的CT值;选择"mono energy"软件测量后得到能谱曲线,并计算其斜率。同时与病理结果进行比较。结果经手术或病理确诊肾上腺少脂肪型腺瘤22例,肾上腺转移瘤28例。经双源CT检查,50例患者中肾上腺少脂肪型腺瘤14例(肾上腺少脂肪型腺瘤组),肾上腺转移瘤36例(转移瘤组)。肾上腺少脂肪型腺瘤组与转移瘤组的融合图像平均CT值分别为(30.6±15.8)HU和(37.3±16.5)HU,差异无统计学意义(t=1.14,P0.05);两组能谱曲线平均斜率分别为(-0.23±0.12)、(0.37±0.33),差异有统计学意义(t=2.36,P0.05)。以能谱曲线斜率0.04为诊断阈值鉴别肾上腺少脂肪型腺瘤与转移瘤时,曲线下面积为0.901、灵敏度为91.8%、特异度为81.8%。结论双源CT诊断肾上腺少脂肪型腺瘤和转移瘤的结果,与手术或病理确诊结果的符合程度较高,且经双源CT检查时,肾上腺少脂肪型腺瘤的能谱曲线斜率高于转移瘤,因此双源CT能谱成像可能成为鉴别肾上腺少脂肪型腺瘤与转移瘤的有用工具。
[Abstract]:Objective to investigate the value of dual source CT in the differential diagnosis of adrenal oligoadipose adenoma and metastatic tumor. Methods from May 2011 to December 2012, 50 patients with adrenal nodules in Hebei Medical University 4th Hospital were treated with double source CT scan. The CT values of the lesions in the fusion images were measured. The energy spectrum curve was obtained by using "mono energy" software, and the slope was calculated. Results 22 cases of adrenal oligoaliphatic adenoma were confirmed by operation or pathology, and the results were compared with those of pathology. There were 28 cases of adrenal metastases. Among them, 14 cases were adrenal oligoadipose adenoma (adrenal oligoadipose adenoma), 36 cases were adrenal metastasis (metastasis group). The mean CT values of fusion images in the tumor group were 30.6 卤15.8HU and 37.3 卤16.5HUU, respectively. There was no significant difference between the two groups, and the mean slope of the energy spectrum curve was -0.23 卤0.12, 0.37 卤0.33, respectively. The difference was statistically significant. The slope of the energy spectrum curve was 0.04 as the diagnostic threshold for the differential diagnosis of adrenal adipose. Type A adenoma and metastatic tumor, The area under the curve is 0.901, the sensitivity is 91.8 and the specificity is 81.8. Conclusion the results of dual-source CT in diagnosis of adrenal oligoadipose adenoma and metastatic tumor are in good agreement with the results of surgical or pathological diagnosis. The slope of energy spectrum curve of adrenal oligoadipose adenoma is higher than that of metastatic tumor, so dual-source CT energy dispersive imaging may be a useful tool for differentiating adrenal oligoadipose adenoma from metastatic tumor.
【作者单位】：河北医科大学第四医院CT、MR室;
【基金】：河北省卫生厅医学科学研究重点课题计划项目(200905011)
【分类号】：R736.6;R730.44

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