能谱CT三期增强在鉴别肝脏局灶性结节增生和肝细胞癌中的价值

发布时间：2018-02-01 18:33

本文关键词： 体层摄影术 X线计算机肝局灶性结节增生肝细胞癌能谱成像鉴别诊断　出处：《中国医学计算机成像杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的:探讨能谱CT定量分析在鉴别肝脏局灶性结节增生(FNH)与肝细胞癌(HCC)中的价值。方法:回顾性分析2013年2月至12月期间经病理证实的肝占位患者35例,其中FNH 14例,HCC 21例,所有患者均行CT平扫及能谱模式三期动态增强扫描。测量增强三期病灶、肝组织以及腹主动脉的能谱参数,包括:55~75keV(间隔5keV)CT值和碘浓度。分别计算三期病灶与腹主动脉、病灶与肝组织各能谱参数的比值,包括:55~75keV的病灶与腹主动脉CT值之比(LARHU)、病灶与腹主动脉碘浓度比值(LARIC)、55~75keV的病灶与肝组织CT值之比(LHRHU)、病灶与肝组织碘浓度比值(LHRIC)。对FNH和HCC两组间上述指标进行两独立样本t检验和ROC曲线分析。结果:除动脉期(55~65keV)LHRHU、LHRIC值外,参数单能量CT值、碘浓度、LARHU、LARIC、LHRHU、LHRIC在三期增强FNH均明显高于HCC(P0.05)。ROC曲线分析示:联合应用定量参数门脉期60keV-LARHU、延迟期75keV-LHRHU对两种疾病进行鉴别,能够提高诊断敏感度和特异度,分别为92.9%和100%。结论:三期增强能谱CT的单能量图像及碘浓度,在鉴别FNH和HCC中具有重要价值。
[Abstract]:Objective: to investigate the value of quantitative analysis of energy dispersive CT in differentiating focal nodular hyperplasia (FNH) from hepatocellular carcinoma (HCC). Methods: from February 2013 to December, 35 patients with hepatic occupying were retrospectively analyzed. Among the 21 patients with FNH, all patients underwent plain CT scan and three phase dynamic enhanced scan with energy dispersive mode. The energy spectrum parameters of the lesions, liver tissue and abdominal aorta were measured. The ratio of the energy spectrum parameters of the three stage lesions to the abdominal aorta, the focus and liver tissue was calculated, including the CT value and iodine concentration of 5 Kev at intervals of 5 Kev and 75 Kev, and the ratio of the three stage lesions to the abdominal aorta and the hepatic tissue. The ratio of the lesion to the CT value of abdominal aorta and the ratio of the focus to the iodine concentration of the abdominal aorta were determined by the ratio of the foci to the abdominal aorta iodine concentration (Laric). The ratio of the lesion to the CT value of liver tissue in 55 ~ 75keV was compared with that of LHRHU. The ratio of iodine concentration between focus and liver tissue was determined by LHRIC.Two independent samples t test and ROC curve analysis were performed on the above indexes between FNH and HCC. Results: the arterial phase was removed from 55 ~ 65keV). LHRHU. In addition to LHRIC, the parameters of single energy CT and iodine concentration were LHRHU. LHRIC enhanced FNH in three phases was significantly higher than that in HCC(P0.05).ROC curve analysis: combined with quantitative parameter 60keV-LARHU in portal phase. The differential diagnosis of the two diseases with 75keV-LHRHU can improve the diagnostic sensitivity and specificity. Conclusion: the single energy image and iodine concentration of three phase enhanced energy spectrum CT have important value in differentiating FNH from HCC.
【作者单位】：上海交通大学医学院附属精神卫生中心医学影像科;同济大学附属同济医院医学影像科;第二军医大学附属东方肝胆外科医院影像科;
【基金】：上海市卫生和计划生育委员会科研基金No.20134y120~~
【分类号】：R730.44;R735.7
【正文快照】： 肝脏局灶性结节增生(focal nodular hyperplasia,FNH)和肝细胞癌(hepatocellular carcinoma,HCC)是肝脏常见的占位性富血供病变。FNH是一种无恶变的良性肿瘤,有部分病灶可自行消退[1],一般不需要处理;肝癌恶性程度及病死率高,早期诊断是使患者获得早期治疗和延长生存期的关键

【相似文献】