本文關(guān)鍵詞： 能譜 體層攝影術(shù) X線計(jì)算機(jī) 腎上腺病變　出處：《南京醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討寶石CT動(dòng)脈單期能譜成像定量分析在鑒別腎上腺良惡性病變中的應(yīng)用價(jià)值。 材料與方法：本研究已通過醫(yī)院倫理委員會(huì)的批準(zhǔn)，并獲得患者的知情同意。回顧性分析2011年6月至2012年3月間,72例（男性33例，女性39例）腎上腺病變的患者及10例（男性6例,女性4例）腎上腺正常的患者，采用64排寶石能譜CT（Discovery CT750HD, GE）選擇動(dòng)脈期能譜成像，自動(dòng)生成101組單能量圖像及碘-脂基物質(zhì)圖，，獲得包含不同腎上腺病灶及感興趣區(qū)的能譜曲線圖及碘-脂含量圖，按不同病理類型分別對(duì)上述碘、脂含量，能譜曲線斜率（λ_HU）及混合能量圖像上相應(yīng)部位的CT值進(jìn)行比較。所有病灶最終經(jīng)病理、腎上腺靜脈采血或隨訪確診。 結(jié)果：共確診128個(gè)病灶含腎上腺增生54個(gè)（組A），腺瘤33個(gè)（組B），轉(zhuǎn)移瘤21個(gè)(組C)，并將20個(gè)正常腎上腺作為對(duì)照組（組D）進(jìn)行研究。單因素方差分析證實(shí)惡性腎上腺病變（組C，3.40±0.98,985.12±6.52和1.55±0.13）在碘、脂含量及能譜曲線斜率（λ_HU）之間均低于良性腎上腺病變(組A,4.18±0.76,993.37±3.65和1.84±0.13,組B,4.65±0.89,997.95±4.32和1.98±0.12)(P值均＜0.001)；組B及組C分別與組D在碘、脂含量及能譜曲線斜率（λ_HU）間存在統(tǒng)計(jì)學(xué)差異(P值均＜0.01)，而組A與組D在碘(P=0.96)、脂含量(P=0.37)及λ_HU(P=0.14)間不存在統(tǒng)計(jì)學(xué)差異。對(duì)于混合能量下的CT值,組A、組B、組C和組D間均不存在統(tǒng)計(jì)學(xué)差異(P=0.70)。 結(jié)論：動(dòng)脈單期能譜掃描單能量重建及物質(zhì)定量分析對(duì)于鑒別腎上腺病變的良惡性以及區(qū)分腎上腺增生與腫瘤具有一定的臨床價(jià)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 鹵0.98U, 985.12 鹵6.52 and 1.55 鹵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 鹵0. 76, 993.37 鹵3. 65 and 1. 84 鹵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.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R730.44;R736.6

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