本文選題：計算機體層攝影　切入點：能譜成像　出處：《大連醫(yī)科大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討CT能譜成像對普通CT難以區(qū)分的膀胱后壁癌與前列腺增生突向膀胱的鑒別診斷價值。 方法：2011年7月至2012年4月在我院行能譜CT檢查并經(jīng)病理證實41例患者（膀胱后壁癌20例，前列腺增生突入膀胱內(nèi)21例），分別在40-140keV條件下在膀胱后壁癌、前列腺增生入膀胱內(nèi)組織及各自自身前列腺組織內(nèi)取感興趣區(qū)ROI，獲得四組數(shù)值不同keV水平的CT值，及CT能譜曲線，分析其差異性。對膀胱后壁癌與自身前列腺組織、前列腺增生突入膀胱內(nèi)與自身前列腺組織計量資料進行配對t檢驗。對膀胱后壁癌組和前列腺增生突入膀胱內(nèi)組的計量資料進行獨立樣本t檢驗。計算并比較膀胱后壁癌與前列腺增生突入膀胱內(nèi)能譜曲線斜率。 結(jié)果：在不同keV條件下，膀胱后壁癌與自身前列腺組織兩者有著不同的CT值，在50-70keV條件下，兩者CT值差異無統(tǒng)計學(xué)意義，余keV條件下兩者CT值差異有統(tǒng)計學(xué)意義，而在100keV其CT值差異最大，分別為（25.88±5.77）（38.39±3.11）HU，差異有統(tǒng)計學(xué)意義，（t=-5.776，p=0.002）。而前列腺增生突入膀胱內(nèi)與自身前列腺組織之間不同keV條件下CT值差異無統(tǒng)計學(xué)意義。在不同keV條件下，膀胱后壁癌與前列腺增生突入膀胱內(nèi)兩者有著不同的CT值，在40-50keV條件下，兩者CT值差異有統(tǒng)計學(xué)意義，在60-90keV條件下，兩者CT值差異無統(tǒng)計學(xué)意義，而后keV能量越高，其CT值差別越大。在40keV，其CT值差異最大，分別為（104.29±18.89）、（61.76±13.62）HU，差異有統(tǒng)計學(xué)意義（t=-4.711，p=0.001）。膀胱后壁癌組能譜曲線斜率（k=0.86）明顯大于前列腺增生突入膀胱內(nèi)曲線斜率(k=0.25)。 結(jié)論：低能量keV圖像在膀胱后壁癌和前列腺增生突入膀胱內(nèi)鑒別中起重要作用，膀胱后壁癌與前列腺增生突入膀胱內(nèi)的組織具有不同的能譜曲線，且能譜曲線斜率較大時提示病變來源于膀胱。CT能譜成像可以較準(zhǔn)確區(qū)分膀胱后壁癌與前列腺增生突入膀胱內(nèi)的組織，提高術(shù)前診斷正確率。
[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 鹵5.77 Hu, 38.39 鹵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 鹵18.89, 61.76 鹵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.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R816.7;R737.14;R697.3

【參考文獻】

相關(guān)期刊論文 前10條

1 周觀寶;周利民;張文偉;;膀胱癌的MSCT診斷[J];放射學(xué)實踐;2009年01期

2 呂培杰;;CT能譜成像在小肝癌檢測中的應(yīng)用價值[J];放射學(xué)實踐;2011年03期

3 楊宗珂;王德林;;超聲造影在膀胱癌診斷中的應(yīng)用進展[J];廣東醫(yī)學(xué);2009年03期

4 周國興;沈璐;趙江民;王葳;王軟斌;宗根林;汪波;郝楠馨;;3.0T MR擴散加權(quán)成像對膀胱癌T分期的診斷價值[J];臨床放射學(xué)雜志;2011年05期

5 張云萍;;前列腺增生26例磁共振成像征象分析[J];山西醫(yī)藥雜志(下半月刊);2011年02期

6 修建軍;崔允峰;劉慶偉;趙素紅;李軼新;張偉;;幾種CT檢查方法對發(fā)現(xiàn)膀胱腫瘤價值的比較[J];實用放射學(xué)雜志;2006年03期

7 王曉佳;李世賓;雷銘德;韓瑞發(fā);;BPH突入膀胱內(nèi)的長度與相關(guān)并發(fā)癥的比較分析[J];天津醫(yī)藥;2010年08期

8 林曉珠;李衛(wèi)俠;朱延波;董海鵬;呂培杰;繆飛;李劍穎;沈云;陳克敏;;寶石能譜CT在腫瘤診斷中的初步應(yīng)用[J];診斷學(xué)理論與實踐;2010年02期

9 王東,張挽時,熊明輝,喻敏,徐家興;Bladder tumors:dynamic contrast-enhanced axial imaging,multiplanar reformation,three-dimensional reconstruction and virtual cystoscopy using helical CT[J];Chinese Medical Journal;2004年01期

10 杜聯(lián)芳;周洋;李凡;伍瑛;何穎倩;;超聲造影判斷膀胱癌浸潤程度及分期[J];中國醫(yī)學(xué)影像技術(shù);2007年12期

，

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