CT能谱成像在鉴别膀胱后壁癌与前列腺增生突入膀胱中的价值

发布时间：2018-03-16 14:52

本文选题：计算机体层摄影　切入点：能谱成像　出处：《大连医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：探讨CT能谱成像对普通CT难以区分的膀胱后壁癌与前列腺增生突向膀胱的鉴别诊断价值。方法：2011年7月至2012年4月在我院行能谱CT检查并经病理证实41例患者（膀胱后壁癌20例，前列腺增生突入膀胱内21例），分别在40-140keV条件下在膀胱后壁癌、前列腺增生入膀胱内组织及各自自身前列腺组织内取感兴趣区ROI，获得四组数值不同keV水平的CT值，及CT能谱曲线，分析其差异性。对膀胱后壁癌与自身前列腺组织、前列腺增生突入膀胱内与自身前列腺组织计量资料进行配对t检验。对膀胱后壁癌组和前列腺增生突入膀胱内组的计量资料进行独立样本t检验。计算并比较膀胱后壁癌与前列腺增生突入膀胱内能谱曲线斜率。结果：在不同keV条件下，膀胱后壁癌与自身前列腺组织两者有着不同的CT值，在50-70keV条件下，两者CT值差异无统计学意义，余keV条件下两者CT值差异有统计学意义，而在100keV其CT值差异最大，分别为（25.88±5.77）（38.39±3.11）HU，差异有统计学意义，（t=-5.776，p=0.002）。而前列腺增生突入膀胱内与自身前列腺组织之间不同keV条件下CT值差异无统计学意义。在不同keV条件下，膀胱后壁癌与前列腺增生突入膀胱内两者有着不同的CT值，在40-50keV条件下，两者CT值差异有统计学意义，在60-90keV条件下，两者CT值差异无统计学意义，而后keV能量越高，其CT值差别越大。在40keV，其CT值差异最大，分别为（104.29±18.89）、（61.76±13.62）HU，差异有统计学意义（t=-4.711，p=0.001）。膀胱后壁癌组能谱曲线斜率（k=0.86）明显大于前列腺增生突入膀胱内曲线斜率(k=0.25)。结论：低能量keV图像在膀胱后壁癌和前列腺增生突入膀胱内鉴别中起重要作用，膀胱后壁癌与前列腺增生突入膀胱内的组织具有不同的能谱曲线，且能谱曲线斜率较大时提示病变来源于膀胱。CT能谱成像可以较准确区分膀胱后壁癌与前列腺增生突入膀胱内的组织，提高术前诊断正确率。
[Abstract]:Objective: to evaluate the value of CT energy dispersive imaging in differentiating bladder posterior wall carcinoma from prostatic hyperplasia. Methods: from July 2011 to April 2012, 41 cases (20 cases of posterior wall carcinoma of bladder, 21 cases of protrusion of prostatic hyperplasia into bladder) were examined by EDS CT in our hospital. Four groups of CT values with different keV levels and CT energy spectrum curves were obtained, and the difference between the carcinoma of the posterior wall of bladder and its own prostate tissue was analyzed. The measurement data of protuberance of prostatic hyperplasia into bladder and prostatic tissue of oneself were matched t test. The measurement data of posterior wall carcinoma of bladder and protrusion of prostatic hyperplasia into bladder were tested by independent t test. The bladder was calculated and compared. Posterior wall carcinoma and protrusion of prostatic hyperplasia into bladder. Results: under different keV conditions, there were different CT values between bladder posterior wall carcinoma and their own prostate tissue, but there was no significant difference in CT value between them under 50-70 Kev condition, while there was significant difference between them under keV condition. But at 100keV, the CT value was the biggest, which was 25.88 卤5.77 Hu, 38.39 卤3.11hu, the difference was statistically significant, but there was no significant difference in CT value under different keV conditions between protuberance of prostatic hyperplasia into the bladder and prostatic tissue of the prostate. Under different keV conditions, there was no significant difference in CT value between prostatic hyperplasia (BPH) and prostatic tissue (P > 0.05), but there was no significant difference in CT value between BPH and prostatic tissue under different keV conditions. There were different CT values between posterior wall carcinoma of bladder and protuberance of prostatic hyperplasia in bladder. Under 40-50 Kev condition, the difference of CT value was statistically significant. Under 60-90 Kev condition, there was no significant difference in CT value between the two groups, and the higher the keV energy was, the higher the keV energy was. At 40keV, the difference of CT value was 104.29 卤18.89, 61.76 卤13.62HUU, the difference was statistically significant (P < 0.05). The slope of energy spectrum curve of bladder posterior wall cancer group was 0.86), which was significantly larger than that of protrusion into bladder by 0.25% of prostatic hyperplasia (P < 0.05). Conclusion: low energy keV images play an important role in differentiating posterior wall carcinoma of bladder from protuberance of prostatic hyperplasia in bladder. There are different energy spectrum curves between posterior wall carcinoma of bladder and protrusion of prostatic hyperplasia into bladder. When the slope of the energy spectrum curve is large, it is suggested that the lesion originated from bladder. Ct energy spectrum imaging can accurately distinguish the tissue of bladder posterior wall cancer from protrusion of prostatic hyperplasia into bladder, and improve the accuracy of preoperative diagnosis.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.7;R737.14;R697.3

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