能谱CT对肾上腺良恶性病变的鉴别价值

发布时间：2018-02-04 03:53

本文关键词： 能谱体层摄影术 X线计算机肾上腺病变　出处：《南京医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：探讨宝石CT动脉单期能谱成像定量分析在鉴别肾上腺良恶性病变中的应用价值。材料与方法：本研究已通过医院伦理委员会的批准，并获得患者的知情同意。回顾性分析2011年6月至2012年3月间,72例（男性33例，女性39例）肾上腺病变的患者及10例（男性6例,女性4例）肾上腺正常的患者，采用64排宝石能谱CT（Discovery CT750HD, GE）选择动脉期能谱成像，自动生成101组单能量图像及碘-脂基物质图，，获得包含不同肾上腺病灶及感兴趣区的能谱曲线图及碘-脂含量图，按不同病理类型分别对上述碘、脂含量，能谱曲线斜率（λ_HU）及混合能量图像上相应部位的CT值进行比较。所有病灶最终经病理、肾上腺静脉采血或随访确诊。结果：共确诊128个病灶含肾上腺增生54个（组A），腺瘤33个（组B），转移瘤21个(组C)，并将20个正常肾上腺作为对照组（组D）进行研究。单因素方差分析证实恶性肾上腺病变（组C，3.40±0.98,985.12±6.52和1.55±0.13）在碘、脂含量及能谱曲线斜率（λ_HU）之间均低于良性肾上腺病变(组A,4.18±0.76,993.37±3.65和1.84±0.13,组B,4.65±0.89,997.95±4.32和1.98±0.12)(P值均＜0.001)；组B及组C分别与组D在碘、脂含量及能谱曲线斜率（λ_HU）间存在统计学差异(P值均＜0.01)，而组A与组D在碘(P=0.96)、脂含量(P=0.37)及λ_HU(P=0.14)间不存在统计学差异。对于混合能量下的CT值,组A、组B、组C和组D间均不存在统计学差异(P=0.70)。结论：动脉单期能谱扫描单能量重建及物质定量分析对于鉴别肾上腺病变的良恶性以及区分肾上腺增生与肿瘤具有一定的临床价值。
[Abstract]:Objective: to evaluate the value of quantitative analysis of single phase energy dispersive imaging of gemstone CT in differentiating benign and malignant adrenal lesions. Materials and methods: this study was approved by the Hospital Ethics Committee and obtained the informed consent of the patients. A retrospective analysis of 72 cases (33 males) between June 2011 and March 2012 was performed. 39 cases of female) adrenal lesions and 10 cases (male 6 cases, female 4 cases) of normal adrenal gland were selected by CT(Discovery CT750 HD (GE). Energy spectrum curves and lipiodol content diagrams containing different adrenal lesions and regions of interest were obtained. The iodine and lipid contents were determined according to different pathological types. The slope of energy spectrum curve (位 -HUU) was compared with the CT value of the corresponding part on the mixed energy image. All lesions were finally confirmed by pathology, adrenal vein blood collection or follow-up. Results: a total of 128 lesions were confirmed to contain 54 adrenal hyperplasia (group A), 33 adenomas (group B), 21 metastatic tumors (group C), and 20 normal adrenal glands as control group (group D). Univariate ANOVA confirmed malignancy. The changes of adrenal gland (C = 3.40 卤0.98U, 985.12 卤6.52 and 1.55 卤0.13) were found in iodine. The lipid content and the slope of energy spectrum curve were lower than those of benign adrenal lesions (A4. 18 卤0. 76, 993.37 卤3. 65 and 1. 84 卤0. 13, P < 0. 001, P < 0. 001, P < 0. 001, P < 0. 001), and those of group B and group C were iodine with group D, respectively. There was no statistical difference in lipid content and 位 _ tit curve slope (P < 0.01), but there was no statistical difference between group A and group D in iodide (0.96), lipid content (P _ (0.37)) and 位 _ (+) (P _ (0.14)). For the CT value of mixed energy, there was no significant difference between the two groups. There was no statistical difference between group A, group B, group C and group D. Conclusion: single phase energy reconstruction and substance quantitative analysis of arterial single phase energy dispersive scanning are of clinical value in differentiating benign and malignant adrenal lesions and differentiating adrenal hyperplasia from tumor.
【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R730.44;R736.6

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