能谱CT物质分离技术和单能量成像克服肾囊肿伪强化的临床评估

发布时间：2018-09-17 08:52

【摘要】：目的:评估能谱CT物质分离技术和单能量成像克服肾囊肿伪强化的效果。材料与方法:收集2014年9月—2015年3月在我院接受能谱GSI模式平扫及增强扫描的75例肾囊肿患者,男41例,女34例,年龄18~70岁,平均(46.4±14.4)岁;BMI 18.5~25.2 kg/m2,平均(23.91±1.83)kg/m2;腹围70~90 cm,平均(84.73±3.14)cm。将重建薄层单能量图像传入GE AW4.5工作站,采用GSI Viewer分析软件生成碘基图、水基图,记录QC图像上各期肾囊肿的CT值、碘基值及水基值;利用GSI处理/重建平台获得平扫及实质期能谱曲线(X轴为单能量值,Y轴为CT值),记录两条曲线的焦点或最接近点所对应的ke V值,即为消除囊肿伪强化的最佳单能量值,最佳单能量定义为使得肾囊肿在实质期CT值的增加最少的单能量值。每组肾囊肿平扫及实质期的碘基值、水基值的差异采用配对样本t检验;三组肾囊肿平扫及实质期间的CT值差值、碘基值差值、水基值差值的比较采用单因数方差分析;采用单因素方差分析比较三组间BMI、腰围、最佳单能量值的差异;P0.05为差异有统计学意义?结果:5例患者予以排除,其中2例随访过程中肾囊肿直径增大、回声增高,3例失访。70例患者共检出单纯肾囊肿90个,直径0.5~3.5 cm,平均(1.9±1.3)cm。按囊肿大小分为三组,A组(n=30)肾囊肿直径0.5~1.5 cm、B组(n=30)直径1.5~2.5 cm、C组(n=30)直径2.5~3.5 cm。三组肾囊肿患者BMI指数、腹围差异无统计学意义(P均0.05)。三组间实质期与平扫CT值差值总体差异有统计学意义(P0.001),且两两比较差异均有统计学意义(P均0.001)。增强后A、B组实质期CT值增加均超过10 HU,出现了伪强化现象,C组CT值增加小于10HU,无伪强化现象。各组内肾囊肿平扫、实质期间碘基值差异有统计学意义(P均0.001);三组间实质期与平扫碘基值差值总体差异有统计学意义(P0.001),且两两比较差异均有统计学意义(P均0.001),三组中实质期与平扫碘基值的差值均在10(100μg/cm3)以内。A、B组内肾囊肿平扫、实质期水基值的差异具有统计学差异(P均0.05),C组肾囊肿平扫、实质期水基值的差异无统计学差异(P0.05);三组间实质期与平扫水基值差值总体差异有统计学意义(P0.001),且两两比较差异均有统计学意义(P均0.001),三组中实质期与平扫水基值的差值均在10(mg/cm3)以内。三组肾囊肿克服肾囊肿伪强化的最佳单能量的平均值分别为A组:90ke V、B组:85ke V、C组:80ke V,三组肾囊肿克服肾囊肿伪强化的最佳单能量差异具有统计学意义(P0.05)。结论:能谱CT物质分离技术测定肾囊肿实质期碘、水基值时同样会发生碘水基值的“漂移”,肾囊肿越小其发生“漂移”的程度越大,碘基值发生漂移的程度受肾囊肿大小的影响较水基值更明显。能谱CT单能量成像能够克服肾囊肿伪强化现象,且最佳单能量的选择与肾囊肿大小有关,肾囊肿越小,克服肾囊肿伪强化所需的最佳单能量值越高。
[Abstract]:Objective: to evaluate the effect of energy dispersive CT separation and single energy imaging on pseudoenhancement of renal cysts. Materials and methods: 75 patients (male 41, female 34, age 1870 years, mean (46.4 卤14.4) years, GSI 18.5N 25.2 kg/m2, mean (23.91 卤1.83) kg/m2; abdominal circumference 7090 cm, mean (84.73 卤3.14) cm.) underwent EDS GSI mode and enhanced scan in our hospital from September 2014 to March 2015. The reconstructed thin-layer single energy image was introduced into GE AW4.5 workstation, and the iodine base map and water base map were generated by GSI Viewer analysis software. The CT, iodine base and water base values of each stage of renal cyst on QC images were recorded. Using the GSI processing / reconstruction platform to obtain the energy spectrum curve of plain scan and substantive period (X axis is single energy value and Y axis is CT value), and to record the ke V value corresponding to the focal point or the closest point of the two curves, that is, the best single energy value for eliminating pseudoenhancement of cysts. Optimal single energy is defined as the single energy value that minimizes the increase of CT in the renal cyst during the solid phase. The difference of iodine base value and water base value during plain scan and parenchymal phase of renal cyst in each group was tested by paired sample t test, the difference of CT value, iodine base value and water base value during plain scan and parenchymal phase of renal cyst in three groups were compared by single factor variance analysis. Single factor analysis of variance (ANOVA) was used to compare the waist circumference of BMI, among the three groups. The difference of the best single energy value (P0.05) was statistically significant. Results 5 cases were excluded, of which 2 cases were followed up with large diameter of renal cyst and 3 cases with high echo. 90 cases of simple renal cyst were detected in 70 cases. The mean diameter of 0.5 cm, was (1.9 卤1.3) cm.. According to the size of cysts, they were divided into three groups: group A (n = 30), diameter of renal cyst: 0.5 ~ 1.5 cm,B group (n = 30), diameter: 1.5 ~ 2.5 cm,C group (n ~ (30) diameter: 2.5 ~ 3.5 cm. There was no significant difference in BMI index and abdominal circumference among the three groups (all P 0. 05). The difference of CT value between the three groups was statistically significant (P0. 001), and the difference between the two groups was statistically significant (P 0.001). After enhancement, the increase of CT in parenchymal period in group A B was more than 10 HU, and the increase of CT value in group C was less than 10 HU. there was no false enhancement phenomenon. Plain scan of renal cyst in each group, The difference of iodine base value between the three groups was statistically significant (P 0.001), and the difference between the three groups was statistically significant (P0. 001), and the difference between the two groups was statistically significant (all P 0.001), and the difference between the three groups was statistically significant (P < 0. 001), and the difference between the three groups was statistically significant (P < 0. 001), and the difference between the two groups was statistically significant (all P 0.001). The difference of basic values was within 10 渭 g/cm3. The difference of water base value in parenchymal phase was statistically significant (P 0.05). There was no significant difference in the water base value between the three groups (P0.05), and the difference between the three groups was statistically significant (P0. 001), and the difference between the two groups was statistically significant (all P 0.001), and the difference between the three groups was statistically significant (P < 0. 001), and the difference between the three groups was statistically significant (P < 0. 001). All the differences were within 10 (mg/cm3). The average value of the best single energy for overcoming pseudoenhancement of renal cyst in three groups was: group A: 90 ke VX B group: 8 8 ke VX group C group 1: 80 ke V, and the best single energy difference of three groups for overcoming pseudoenhancement of renal cyst was statistically significant (P0.05). Conclusion: determination of iodine in solid phase of renal cyst by energy dispersive CT technique can also occur "drift" of iodine water base value when water base value, the smaller the renal cyst is, the greater the "drift" occurs. The extent of iodide drift was more affected by the size of renal cyst than that of water. EDS CT single energy imaging can overcome pseudo-enhancement phenomenon of renal cysts, and the optimal single energy selection is related to the size of renal cysts. The smaller the renal cysts, the higher the optimal single energy value needed to overcome pseudo-enhancement of renal cysts.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692;R816.7

【相似文献】