本文選題：能譜成像 + 體層攝影術(shù)��； 參考：《臨床軍醫(yī)雜志》2016年09期

【摘要】：目的探討能譜CT定量分析鑒別診斷腎透明細(xì)胞癌(ccRCC)和腎臟乏脂肪血管平滑肌脂肪瘤(RAML)的臨床價(jià)值,以指導(dǎo)臨床治療方案的選擇。方法回顧性分析術(shù)前行腎臟平掃+能譜CT雙期增強(qiáng)掃描并經(jīng)手術(shù)病理證實(shí)的38例ccRCC與9例乏脂肪RAML患者的臨床資料。應(yīng)用能譜分析軟件,測(cè)量并計(jì)算皮、髓質(zhì)期病灶實(shí)性部分的碘濃度(IC)、標(biāo)準(zhǔn)化碘濃度(NIC)、能譜曲線斜率及40~140 keV下的CT值,應(yīng)用獨(dú)立樣本t檢驗(yàn),對(duì)兩組病變各參數(shù)值進(jìn)行比較,繪制ROC曲線,分析IC、NIC、能譜曲線斜率的診斷效能。結(jié)果 ccRCC皮質(zhì)期IC(62.20±19.50)μg/ml、NIC(0.48±0.13)μg/ml分別高于乏脂肪RAML皮質(zhì)期IC(35.82±18.40)μg/ml、NIC(0.26±0.12)μg/ml(P0.05)。ccRCC皮質(zhì)期曲線斜率(8.66±2.53)、髓質(zhì)期曲線斜率(4.86±1.17)分別大于乏脂肪RAML皮質(zhì)期曲線斜率(4.87±2.50)、髓質(zhì)期曲線斜率(3.32±1.30)(P0.05)。ccRCC皮質(zhì)期40~100 keV、髓質(zhì)期40~60 keV下的CT值分別高于乏脂肪RAML皮質(zhì)期40~100 keV、髓質(zhì)期40~60 keV下的CT值(P0.05)。以皮質(zhì)期與髓質(zhì)期IC分別52.14μg/ml與27.76μg/ml、NIC分別0.39與0.69、曲線斜率分別6.35與3.76為閾值診斷,ccRCC的敏感度分別為70.6%與85.3%、73.5%與91.2%、85.3%與85.3%,特異度分別為87.5%與75.0%、100.0%與75.0%、75.0%與75.0%。結(jié)論能譜CT成像及多參數(shù)定量分析對(duì)ccRCC與乏脂肪RAML的鑒別診斷有一定臨床應(yīng)用價(jià)值,有望為術(shù)前治療方案的選擇提供依據(jù)。
[Abstract]:Objective to evaluate the clinical value of quantitative analysis of energy dispersive CT in the differential diagnosis of renal clear cell carcinoma (CCRCC) and renal adipose angiomyolipoma (RML) in order to guide the choice of clinical treatment. Methods the clinical data of 38 patients with CCRCC and 9 patients with adipose raML confirmed by surgery and pathology were retrospectively analyzed. Using the software of energy spectrum analysis, we measured and calculated the iodine concentration of the solid part of the lesion in the skin and medullary phase, the standard iodine concentration, the slope of the energy spectrum curve and the CT value at 40 ~ 140keV. The parameters of the two groups were compared with each other by t-test. The ROC curve was drawn, and the diagnostic efficiency of the slope of ICNIC and energy spectrum curve was analyzed. 緇撴灉 ccRCC鐨川鏈烮C(62.20鹵19.50)渭g/ml,NIC(0.48鹵0.13)渭g/ml鍒嗗埆楂樹簬涔忚剛鑲猂AML鐨川鏈烮C(35.82鹵18.40)渭g/ml,NIC(0.26鹵0.12)渭g/ml(P0.05).ccRCC鐨川鏈熸洸綰挎枩鐜，

本文編號(hào)：2006829