【摘要】：目的:評(píng)估能譜CT物質(zhì)分離技術(shù)和單能量成像克服腎囊腫偽強(qiáng)化的效果。材料與方法:收集2014年9月—2015年3月在我院接受能譜GSI模式平掃及增強(qiáng)掃描的75例腎囊腫患者,男41例,女34例,年齡18~70歲,平均(46.4±14.4)歲;BMI 18.5~25.2 kg/m2,平均(23.91±1.83)kg/m2;腹圍70~90 cm,平均(84.73±3.14)cm。將重建薄層單能量圖像傳入GE AW4.5工作站,采用GSI Viewer分析軟件生成碘基圖、水基圖,記錄QC圖像上各期腎囊腫的CT值、碘基值及水基值;利用GSI處理/重建平臺(tái)獲得平掃及實(shí)質(zhì)期能譜曲線(X軸為單能量值,Y軸為CT值),記錄兩條曲線的焦點(diǎn)或最接近點(diǎn)所對(duì)應(yīng)的ke V值,即為消除囊腫偽強(qiáng)化的最佳單能量值,最佳單能量定義為使得腎囊腫在實(shí)質(zhì)期CT值的增加最少的單能量值。每組腎囊腫平掃及實(shí)質(zhì)期的碘基值、水基值的差異采用配對(duì)樣本t檢驗(yàn);三組腎囊腫平掃及實(shí)質(zhì)期間的CT值差值、碘基值差值、水基值差值的比較采用單因數(shù)方差分析;采用單因素方差分析比較三組間BMI、腰圍、最佳單能量值的差異;P0.05為差異有統(tǒng)計(jì)學(xué)意義?結(jié)果:5例患者予以排除,其中2例隨訪過(guò)程中腎囊腫直徑增大、回聲增高,3例失訪。70例患者共檢出單純腎囊腫90個(gè),直徑0.5~3.5 cm,平均(1.9±1.3)cm。按囊腫大小分為三組,A組(n=30)腎囊腫直徑0.5~1.5 cm、B組(n=30)直徑1.5~2.5 cm、C組(n=30)直徑2.5~3.5 cm。三組腎囊腫患者BMI指數(shù)、腹圍差異無(wú)統(tǒng)計(jì)學(xué)意義(P均0.05)。三組間實(shí)質(zhì)期與平掃CT值差值總體差異有統(tǒng)計(jì)學(xué)意義(P0.001),且兩兩比較差異均有統(tǒng)計(jì)學(xué)意義(P均0.001)。增強(qiáng)后A、B組實(shí)質(zhì)期CT值增加均超過(guò)10 HU,出現(xiàn)了偽強(qiáng)化現(xiàn)象,C組CT值增加小于10HU,無(wú)偽強(qiáng)化現(xiàn)象。各組內(nèi)腎囊腫平掃、實(shí)質(zhì)期間碘基值差異有統(tǒng)計(jì)學(xué)意義(P均0.001);三組間實(shí)質(zhì)期與平掃碘基值差值總體差異有統(tǒng)計(jì)學(xué)意義(P0.001),且兩兩比較差異均有統(tǒng)計(jì)學(xué)意義(P均0.001),三組中實(shí)質(zhì)期與平掃碘基值的差值均在10(100μg/cm3)以內(nèi)。A、B組內(nèi)腎囊腫平掃、實(shí)質(zhì)期水基值的差異具有統(tǒng)計(jì)學(xué)差異(P均0.05),C組腎囊腫平掃、實(shí)質(zhì)期水基值的差異無(wú)統(tǒng)計(jì)學(xué)差異(P0.05);三組間實(shí)質(zhì)期與平掃水基值差值總體差異有統(tǒng)計(jì)學(xué)意義(P0.001),且兩兩比較差異均有統(tǒng)計(jì)學(xué)意義(P均0.001),三組中實(shí)質(zhì)期與平掃水基值的差值均在10(mg/cm3)以內(nèi)。三組腎囊腫克服腎囊腫偽強(qiáng)化的最佳單能量的平均值分別為A組:90ke V、B組:85ke V、C組:80ke V,三組腎囊腫克服腎囊腫偽強(qiáng)化的最佳單能量差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:能譜CT物質(zhì)分離技術(shù)測(cè)定腎囊腫實(shí)質(zhì)期碘、水基值時(shí)同樣會(huì)發(fā)生碘水基值的“漂移”,腎囊腫越小其發(fā)生“漂移”的程度越大,碘基值發(fā)生漂移的程度受腎囊腫大小的影響較水基值更明顯。能譜CT單能量成像能夠克服腎囊腫偽強(qiáng)化現(xiàn)象,且最佳單能量的選擇與腎囊腫大小有關(guān),腎囊腫越小,克服腎囊腫偽強(qiáng)化所需的最佳單能量值越高。
[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 鹵14.4) years, GSI 18.5N 25.2 kg/m2, mean (23.91 鹵1.83) kg/m2; abdominal circumference 7090 cm, mean (84.73 鹵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 鹵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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R692;R816.7

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