發(fā)布時間：2018-09-17 08:52

【摘要】：目的:評估能譜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/重建平臺獲得平掃及實質(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或最接近點所對應的ke V值,即為消除囊腫偽強化的最佳單能量值,最佳單能量定義為使得腎囊腫在實質(zhì)期CT值的增加最少的單能量值。每組腎囊腫平掃及實質(zhì)期的碘基值、水基值的差異采用配對樣本t檢驗;三組腎囊腫平掃及實質(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)計學意義?結(jié)果:5例患者予以排除,其中2例隨訪過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,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)、腹圍差異無統(tǒng)計學意義(P均0.05)。三組間實質(zhì)期與平掃CT值差值總體差異有統(tǒng)計學意義(P0.001),且兩兩比較差異均有統(tǒng)計學意義(P均0.001)。增強后A、B組實質(zhì)期CT值增加均超過10 HU,出現(xiàn)了偽強化現(xiàn)象,C組CT值增加小于10HU,無偽強化現(xiàn)象。各組內(nèi)腎囊腫平掃、實質(zhì)期間碘基值差異有統(tǒng)計學意義(P均0.001);三組間實質(zhì)期與平掃碘基值差值總體差異有統(tǒng)計學意義(P0.001),且兩兩比較差異均有統(tǒng)計學意義(P均0.001),三組中實質(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、實質(zhì)期水基值的差異具有統(tǒng)計學差異(P均0.05),C組腎囊腫平掃、實質(zhì)期水基值的差異無統(tǒng)計學差異(P0.05);三組間實質(zhì)期與平掃水基值差值總體差異有統(tǒng)計學意義(P0.001),且兩兩比較差異均有統(tǒng)計學意義(P均0.001),三組中實質(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化的最佳單能量差異具有統(tǒng)計學意義(P0.05)。結(jié)論:能譜CT物質(zhì)分離技術(shù)測定腎囊腫實質(zhì)期碘、水基值時同樣會發(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.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R692;R816.7

【相似文獻】

相關(guān)期刊論文 前10條

1 ;“泵式內(nèi)吸法”消除肝腎囊腫[J];支部建設;2000年07期

2 劉鑫國,何濟穎,汪訓寶,俞培基,賀學勤,余秀武,王榮平;腹膜后腹腔鏡手術(shù)治療腎囊腫2例[J];臨床中老年保健;2003年04期

3 張華文,楊成天,楊乾滋;罕見巨大腎囊腫一例[J];臨床外科雜志;2005年07期

4 趙現(xiàn)朝;;消囊丹治療腎囊腫73例[J];陜西中醫(yī);2011年08期

5 沙依塔吉·哈斯木;;腎囊腫3種治療方法的比較(附30例報告)[J];中國社區(qū)醫(yī)師(醫(yī)學專業(yè));2013年01期

6 鄭忠東;多腔性腎囊腫[J];湛江醫(yī)學院學報;1993年Z1期

7 任福錦,詹朝暉;單純腎囊腫28例治療分析[J];浙江醫(yī)學;1998年10期

8 ;肝腎囊腫病的治療有突破[J];專業(yè)戶;1999年01期

9 王崇文;;腎囊腫應怎樣治療[J];老友;2008年12期

10 王崇文;;腎囊腫怎樣治療[J];老友;2008年08期

相關(guān)會議論文 前10條

1 裴振東;吉光宇;王升光;孔凡樹;李靜;蘇福云;;超聲引導注入硝酸銀治療腎囊腫68例報告[A];中國中西醫(yī)結(jié)合學會泌尿外科專業(yè)委員會第三屆全國學術(shù)會議論文匯編[C];2001年

2 肖家全;白虹;祁小龍;鄒強;樓水鑫;任黎剛;章越龍;丁青;茅夏娃;章偉;董志超;;非典型腎囊腫的診治[A];浙江省中西醫(yī)結(jié)合學會泌尿外科、男科專業(yè)委員會第五次學術(shù)年會暨國家級繼續(xù)教育學習班資料匯編[C];2007年

3 王固新;夏昕暉;夏利萍;譚明波;曹哲;姜海洋;張定;;腹膜后腹腔鏡手術(shù)治療腎囊腫(附23例報告)[A];第十五屆全國泌尿外科學術(shù)會議論文集[C];2008年

4 胡少煒;高文喜;張忠明;邢魯斌;俞承榮;侯春華;伍文兵;;后腹腔鏡治療復雜性腎囊腫的探討[A];第七次中國中西醫(yī)結(jié)合泌尿外科學術(shù)年會暨第二次廣東省中西醫(yī)結(jié)合泌尿外科學術(shù)年會論文集[C];2009年

5 曾雪云;朱慧華;夏耘;萬少華;吳峰;;后腹腔鏡下腎囊腫治療體會[A];2006年浙江省微創(chuàng)外科學術(shù)會議論文匯編[C];2006年

6 曾雪云;夏耘;朱慧華;萬少華;吳峰;;后腹腔鏡下腎囊腫治療體會[A];第三屆浙江中西部科技論壇論文集（第七卷 醫(yī)學、抗癌分卷）[C];2006年

7 宋建明;陳衛(wèi)華;凌月蓉;葉軍;;超聲引導穿刺腎囊腫無水乙醇硬化術(shù)[A];中國超聲醫(yī)學工程學會第八屆全國腹部超聲學術(shù)會議論文匯編[C];2010年

8 胡衛(wèi)鋒;李文洲;李運柱;陳琳;余家俊;;腎囊腫硬化治療的病理研究[A];第十五屆全國泌尿外科學術(shù)會議論文集[C];2008年

9 胡俊杰;劉福泉;許曉源;童高寅;潘惠仙;徐水;胡躍剛;;后腹腔鏡去頂減壓術(shù)治療腎囊腫15例分析[A];2008年浙江省泌尿外科學術(shù)年會論文匯編[C];2008年

10 楊發(fā)武;呂更生;王二慶;周魯財;徐欽華;汪磊;張海洋;趙熊;;腹膜后腹腔鏡手術(shù)治療腎囊腫20例報告[A];華東六省一市泌尿外科學術(shù)年會暨2011年浙江省泌尿外科、男科學學術(shù)年會論文匯編[C];2011年

相關(guān)重要報紙文章 前10條

1 記者 李天舒　通訊員 朱丹萍;腎囊腫致病原因被發(fā)現(xiàn)[N];健康報;2011年

2 ;腎囊腫要不要治療？[N];中國人口報;2004年

3 王輝;腎囊腫何時需治療[N];健康時報;2004年

4 安徽省黃山市文化局 劉松;白面瓢治腎囊腫[N];健康時報;2005年

5 江西醫(yī)學院一附院泌外科 教授 彭軾平;莫被腎囊腫嚇著[N];家庭醫(yī)生報;2003年

6 邵開江;腎囊腫要不要治療[N];衛(wèi)生與生活報;2003年

7 主治醫(yī)師 肖祥云;腎臟長囊腫之后怎么辦[N];衛(wèi)生與生活報;2005年

8 于峰;發(fā)現(xiàn)肝腎囊腫怎么辦？[N];大眾衛(wèi)生報;2007年

9 金文;得了腎囊腫怎么辦[N];醫(yī)藥養(yǎng)生保健報;2007年

10 中國中醫(yī)科學院西苑醫(yī)院泌尿外科副主任醫(yī)師 高瞻;老年腎囊腫有“金標準”[N];健康時報;2008年

相關(guān)碩士學位論文 前2條

1 劉宏;能譜CT物質(zhì)分離技術(shù)和單能量成像克服腎囊腫偽強化的臨床評估[D];吉林大學;2017年

2 王文苓;羧酸類化合物DJ5抑制腎囊腫形成的作用和機制[D];第二軍醫(yī)大學;2012年

，

本文編號：2245350