【摘要】：第一部分第二代雙源CT虛擬平掃在腎臟占位中的應(yīng)用 目的： 探討第二代雙源CT虛擬平掃(VNC)在腎臟占位性病變中的臨床應(yīng)用價(jià)值。方法： 對(duì)52例腎臟占位性病變的患者行常規(guī)CT平掃和雙能量CT增強(qiáng)掃描。經(jīng)liverVNC獲得虛擬平掃（VNC）圖像，由兩名醫(yī)師對(duì)VNC和常規(guī)平掃的圖像質(zhì)量及病灶顯示情況進(jìn)行評(píng)價(jià)，測(cè)量雙腎病變區(qū)平均CT值、SNR及輻射劑量，并進(jìn)行比較。 結(jié)果： VNC圖像在病灶顯示方面完全滿足診斷要求，與常規(guī)平掃比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)，3例鈣化灶在VNC顯示較常規(guī)平掃體積縮小。所測(cè)量各部位VNC平均CT值與常規(guī)平掃差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；利用t檢驗(yàn)對(duì)比分析VNC與常規(guī)平掃選在腎實(shí)質(zhì)、腰大肌、主動(dòng)脈及腎占位的圖像，虛擬平掃（VNC）SNR略低于常規(guī)平掃(P0.05)；虛擬平掃單期DLP、有效劑量ED分別為464.50±207.37mGycm、6.96±3.11mSv，均低于常規(guī)平掃的640.94±195.26mGycm、9.16±2.92mSv，差異均有統(tǒng)計(jì)學(xué)意義(t值分別為4.842、2.588，P值均0.05）。 結(jié)論： 對(duì)與腎臟占位性病變，第二代雙源CT可提供高質(zhì)量虛擬圖像，，并且將明顯低輻射劑量。 第二部分雙源CT雙能量掃描碘圖在腎臟惡性占位中的應(yīng)用 目的: 探討雙能CT雙能量掃描碘圖在腎臟惡性占位中的應(yīng)用價(jià)值。 方法: 回顧性分析并經(jīng)病理證實(shí)的35例腎細(xì)胞癌，測(cè)定腎臟腫瘤皮髓交界期、實(shí)質(zhì)期、腹主動(dòng)脈的含碘濃度及病灶與主動(dòng)脈含碘濃度比值。比較透明細(xì)胞癌和非透明細(xì)胞癌兩組病灶碘偽彩色分布的變化進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果: 29例為透明細(xì)胞癌，6例為非透明細(xì)胞癌。透明細(xì)胞癌在皮髓交界期碘基圖像上分別均高于非透明細(xì)胞癌，差異具有明顯統(tǒng)計(jì)學(xué)意義（t=7.048、t=6.325，P0.05）（附圖2），在實(shí)質(zhì)期碘基圖像上的病灶內(nèi)碘濃度、病灶與腹主動(dòng)脈碘濃度比值數(shù)值的差別無(wú)統(tǒng)計(jì)學(xué)意義（t=5.294、t=4.35，P0.05）。 結(jié)論: 雙能量CT碘分布圖像可以提供更直觀的腫瘤強(qiáng)化的信息。
[Abstract]:Part one the application of the second generation dual-source CT virtual plain scan in renal space occupying objective: to investigate the clinical value of the second generation dual-source CT virtual plain-scan (VNC) in renal space-occupying lesions. Methods: routine CT plain scan and dual energy CT enhanced scan were performed in 52 patients with renal space occupying lesions. Virtual plain scan (VNC) images were obtained by liverVNC. The image quality and lesion display of VNC and conventional plain scan were evaluated by two physicians. The average CT value, SNR and radiation dose of bilateral renal lesions were measured and compared. Results: VNC images completely met the requirements of diagnosis, and there was no significant difference compared with conventional plain scan (P0.05). The volume of calcified foci in 3 cases was smaller than that in conventional plain scan on VNC. There was no significant difference between the average CT value of VNC measured and the conventional plain scan (P0.05). T-test was used to compare the images of VNC and conventional plain scan in renal parenchyma, psoas major muscle, aorta and kidney. The (VNC) SNR of virtual plain scan was slightly lower than that of conventional plain scan (P0.05). The effective doses of DLP, in single phase of virtual plain scan were 464.50 鹵207.37mGy / cm and 6.96 鹵3.11mSvrespectively, which were lower than those of conventional plain scan (640.94 鹵195.26mGy / cm, 9.16 鹵2.92mSvv, t = 4.842, 2.588, P < 0.05). Conclusion: the second generation dual-source CT can provide high-quality virtual images with significantly lower radiation dose for space-occupying lesions of the kidney. The second part is the application of dual-source CT dual-energy imaging in renal malignant space-occupying. Objective: to explore the application value of dual-energy CT dual-energy scanning iodine imaging in renal malignant space occupying. Methods: 35 cases of renal cell carcinoma confirmed by pathology were retrospectively analyzed. The iodine concentration of abdominal aorta and the ratio of lesion to aortic iodine concentration were measured in the junctional and parenchyma phases of renal tumors. The changes of iodine pseudo-color distribution between clear cell carcinoma and non-transparent cell carcinoma were analyzed statistically. Results: 29 cases were clear cell carcinoma and 6 cases were non-transparent cell carcinoma. The iodine concentration in the solid-phase iodine-based images of clear cell carcinoma was significantly higher than that in non-transparent cell carcinoma (t = 7.048, t = 6.325, P 0.05) (figure 2), and the iodine concentration of the lesions in solid phase was significantly higher than that in non-transparent cell carcinoma (t = 7.048, t = 6.325, P < 0.05). There was no significant difference in iodine concentration ratio between lesion and abdominal aorta (t = 5.294, t = 4.35, P0.05). Conclusion: dual energy CT iodine distribution images can provide more intuitive information of tumor enhancement.
【學(xué)位授予單位】：山西醫(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)】：R816.7

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