能谱CT虚拟平扫在肾脏占位病变的应用探索

发布时间：2018-04-21 17:01

本文选题：肾占位 + 体层摄影术　；参考：《临床放射学杂志》2017年12期

【摘要】：目的探讨在肾脏占位性病变诊断方面,能谱CT虚拟平扫(VNC)能否代替传统CT真实平扫(TNC)。方法回顾性分析本院2013年12月至2015年10月行常规肾脏平扫及能谱双期扫描的54例肾脏占位患者的影像资料。由两位具有多年腹部CT诊断经验的影像诊断医师采用双盲法分别对肾脏TNC、皮质期及髓质期VNC图像进行主观图像质量评分,测量病灶-正常肾实质的对比噪声比(CNR),以单因素方差分析进行组间两两比较。以病理结果为金标准,用χ~2检验分别比较TNC与皮质期或髓质期VNC图像对肾脏病灶检测的敏感性,计算有无统计学意义。结果 54例患者伴有肾脏占位病变72枚,其中肾单纯囊肿24枚,肾透明细胞癌15枚,肾转移瘤14枚,肾复杂囊肿11枚,肾脓肿8枚。两位诊断医师对三组图像评价结果的一致性较好(Kappa值均0.80);TNC、皮质期及髓质期VNC三组图像间图像质量评分差异无统计学差异(P0.05);三组图像病灶-正常肾实质CNR值分别为0.53±0.14、0.72±0.19、0.61±0.16,皮质期及髓质期VNC图像病灶-正常肾实质CNR值均高于TNC,差异均有统计学意义(P0.05);TNC、皮质期及髓质期VNC图像的诊断敏感性分别为62.50%、63.89%及66.67%,差异无统计学意义(P0.05)。结论皮质期及髓质期VNC与TNC图像质量评分并无显著性差异,均能准确地显示肾脏占位性病变。对肾脏占位性病变,能谱VNC图像在一定程度上可代替TNC图像。
[Abstract]:Objective to investigate whether energy dispersive CT virtual plain scan (VNC) can replace traditional CT in the diagnosis of renal space-occupying lesions. Methods from December 2013 to October 2015, the imaging data of 54 patients with renal occupying were analyzed retrospectively. The VNC images of renal TNC, cortical phase and medullary phase were evaluated by two imaging diagnostics with many years of experience in abdominal CT diagnosis by double blind method. The contrastive noise ratio of focus-normal renal parenchyma was measured and compared by univariate ANOVA. The sensitivity of TNC, cortical or medullary VNC images to renal lesions was compared by 蠂 ~ 2 test. Results there were 72 renal lesions in 54 patients, including 24 simple renal cysts, 15 clear cell carcinomas, 14 renal metastases, 11 complex renal cysts and 8 renal abscesses. There was good consistency between the two diagnostics in evaluating the three groups. The Kappa value was 0.80%. There was no significant difference in image quality scores between the cortical and medullary VNC groups (P 0.05), and the CNR values of the focus-normal renal parenchyma in the three groups were respectively. 0.53 卤0.14 卤0.192 卤0.19 0.61 卤0.16. The CNR value of VNC in cortical phase and medullary phase was higher than that in normal renal parenchyma. The diagnostic sensitivity of VNC in cortical phase and medullary phase was 63.89% and 66.67%, respectively. The difference was not statistically significant (P 0.05). Conclusion there is no significant difference between VNC and TNC in cortical phase and medullary stage, and both can accurately display renal occupying lesions. Energy dispersive VNC images can replace TNC images to some extent for renal space-occupying lesions.
【作者单位】：浙江省宁波市宁海县第一医院放射科;浙江省宁波市鄞州人民医院(宁波大学医学院附属鄞州医院)放射科;
【分类号】：R692;R730.44;R737.11

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