双能量能谱CT成像对壶腹周围癌诊断价值

发布时间：2018-04-23 15:55

本文选题：体层摄影术 + X线计算机　；参考：《放射学实践》2015年10期

【摘要】：目的:通过分析壶腹周围癌能谱CT参数特征,探讨能谱成像在判断不同组织来源壶腹部肿瘤中的应用价值。方法:将行能谱CT检查并经手术或活检病理证实的壶腹周围88例分成3组,其中胰头腺癌39例,胆总管末端腺癌22例,十二指肠乳头腺癌27例。分别测量增强各期病灶的能谱曲线斜率、水浓度、碘浓度及标准化碘浓度(NIC),采用单因方差分析和Scheffe检验比较各能谱参数之间的差异。结果:三期增强扫描中,3组之间水浓度无统计学差异(P0.05)。碘浓度:胆总管末端腺癌组分别为动脉期23.34mg/mL,门脉期25.79mg/mL,延迟期25.52mg/mL;十二指肠乳头腺癌组分别为动脉期14.35 mg/mL,门脉期18.15 mg/mL,延迟期19.47 mg/mL;胰头腺癌组分别为:动脉期10.10mg/mL,门脉期13.01mg/mL,延迟期12.88mg/mL。标准化碘浓度:胆总管末端腺癌动脉期0.22,门脉期0.59,延迟期0.85;十二指肠乳头腺癌组动脉期为0.16,门脉期为0.39,延迟期0.59;胰头腺癌组动脉期0.09,门脉期0.30,延迟期0.46。斜率:胆总管末端腺癌组动脉期2.51,门脉期3.07,延迟期2.83;十二指肠乳头腺癌组动脉期斜率为1.64,门脉期斜率为2.11,延迟期斜率为2.21;胰头腺癌组动脉期斜率为1.08,门脉期斜率为1.30,延迟期斜率为1.37;各值均为胆总管末端腺癌组最高,胰腺癌组最低,且两两比较均有统计学差异(P0.05)。结论:CT能谱成像多参数联合诊断有助于鉴别壶腹周围癌的起源。
[Abstract]:Objective: to evaluate the value of energy dispersive imaging in the diagnosis of ampullary tumors from different tissue sources by analyzing the characteristics of energy spectrum CT parameters of periampullary carcinoma. Methods: 88 cases of periampullary carcinoma proved by operation or biopsy were divided into 3 groups: pancreatic head adenocarcinoma (39 cases), choledochal terminal adenocarcinoma (22 cases) and duodenal papillary adenocarcinoma (27 cases). The slope of energy spectrum curve, water concentration, iodine concentration and standardized iodine concentration were measured respectively. The differences of energy spectrum parameters were compared by single cause analysis of variance and Scheffe test. Results: there was no significant difference in water concentration among the three groups in three phase enhanced scanning (P 0.05). Iodine concentrations were 23.34 mg / mL in arterial phase, 25.79 mg / mL in portal phase, 25.52 mg / mL in delayed phase, 14.35 mg / mL in duodenal papillary adenocarcinoma, 18.15 mg / mL in portal vein, 19.47 mg / mL in delayed phase, 10.10 mg / mL in arterial phase, 13.01 mg / mL in portal phase, 12.88 mg / mL in duodenal papillary adenocarcinoma group, respectively. The standardized iodine concentration was 0.22 in arterial phase, 0.59 in portal phase, 0.85 in delayed phase, 0.16 in duodenal papillary adenocarcinoma group, 0.39 in portal phase, 0.59 in delayed phase, 0.09 in arterial phase, 0.30 in portal phase, and 0.46 in duodenal papillary adenocarcinoma group. Slope: arterial phase 2.51, portal phase 3.07, delayed phase 2.83 in duodenal papillary adenocarcinoma group; duodenal papillary adenocarcinoma group, arterial phase slope 1.64, portal phase slope 2.11, delayed phase slope 2.21; pancreatic head adenocarcinoma group, arterial phase slope 1.08, portal slope, portal phase slope 2.21. The slope of delayed period was 1.37, and all the values were the highest in the group of adenocarcinoma at the end of common bile duct. The pancreatic cancer group was the lowest, and there was statistical difference between the two groups (P 0.05). Conclusion the multi-parameter diagnosis of the ampullary periampullary carcinoma with multi-parameter CT energy spectrum imaging is helpful to differentiate the origin of the carcinoma.
【作者单位】：安徽省立医院放射科;安徽医科大学第一附属医院放射科;
【基金】：国家自然科学青年科学基金项目(81501468) 2015年安徽省科技厅公益性技术应用研究联动计划项目(15011d04028)
【分类号】：R735.0;R730.44

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