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山东大学学报（医学版） ›› 2014, Vol. 52 ›› Issue (12): 94-98.doi: 10.6040/j.issn.1671-7554.0.2014.494

• 临床医学 • 上一篇    下一篇

能谱CT在肝细胞癌与肝内肿块型胆管细胞癌鉴别诊断中的应用价值

刘常绪1, 张成琪2, 王新怡2, 杨志强2   

  1. 1. 泰山医学院, 山东 泰安 271000;
    2. 山东大学附属千佛山医院影像科, 山东 济南 250014
  • 收稿日期:2014-07-28 修回日期:2014-11-24 发布日期:2014-12-10
  • 通讯作者: 张成琪。E-mail:chengqizhangsd@126.com E-mail:chengqizhangsd@126.com
  • 基金资助:
    山东省科技发展计划(2011GSF11828)

Application value of spectral CT imaging in differential diagnosis of hepatocellular carcinoma and hepatic mass-type cholangiocarcinoma

LIU Changxu1, ZHANG Chengqi2, WANG Xinyi2, YANG Zhiqiang2   

  1. 1. Taishan Medical University, Taian 271000, Shandong, China;
    2. Department of Medical Imaging, Qianfoshan Hospital Affiliated to Shandong University, Jinan 250014, Shandong, China
  • Received:2014-07-28 Revised:2014-11-24 Published:2014-12-10

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摘要： 目的 探讨能谱CT在肝细胞癌与肝内肿块型胆管细胞癌鉴别诊断中的应用价值。方法 行能谱CT扫描并经病理证实的肝癌患者34例(肝细胞癌20例、肝内肿块型胆管细胞癌14例),通过能谱分析软件,获取肿块内感兴趣区的碘基图、水基图及101组单能量图像,分析单能量55 Kev下对应的碘含量、水含量、能谱曲线及标准化后碘含量。用独立样本t检验分析上述参数。结果 肝细胞癌的碘含量、能谱曲线斜率、标准化后碘含量分别为(12.84±2.38)、(1.58±0.24)、(0.15±0.05)μg/cm3,肝内肿块型胆管细胞癌分别为(10.71±3.01)、(1.34±0.32)、(0.12±0.34)μg/cm3。肝细胞癌与肝内肿块型胆管细胞癌的碘含量、能谱曲线斜率、标准化后碘含量差异均有统计学意义(P<0.05)。肝细胞癌与肝内肿块型胆管细胞癌的水含量分别为(1041.05±6.47)、(1 038.74±8.54)mg/cm3,差异无统计学意义(P>0.05)。结论 能谱CT成像及多参数分析,对肝细胞癌与肝内肿块型胆管细胞癌鉴别诊断中有一定价值。

关键词: 能谱成像, 肝癌, 体层摄影术

Abstract: Objective To explore the application value of spectral CT imaging in the differential diagnosis of hepatocellular carcinoma and hepatic mass-type cholangiocarcinoma. Methods A total of 34 liver cancer cases, including 20 hepatocellular carcinoma and 14 hepatic mass-type cholangiocarcinoma, underwent spectral CT scan. Iodine concentration, water concentration and 101 sets of monochromatic images were generated with gemstone spectral imaging post-processing software. The iodine concentration, water concentration, spectrum energy curve and normalized iodine concentration were measured at the monochromatic energy 55 Kev. The results were analyzed with independent samples t test. Results In hepatocellular carcinoma, the iodine concentration, spectrum energy curve and normalized iodine concentration were (12.84±2.38), (1.58±0.24) and (0.15±0.05) μg/cm3; while in cholangiocarcinoma, those were (10.71±3.01), (1.34±0.32) and (0.12±0.34) μg/cm3. There were significant differences between those indexes (P<0.05). The water concentration in hepatocellular carcinoma and cholangiocarcinoma were (1 041.05±6.47) and (1038.74±8.54) mg/cm3, respectively, exhibiting no significant difference (P>0.05). Conclusion Spectral CT is helpful for the differential diagnosis of hepatocellular carcinoma and hepatic mass-type cholangiocarcinoma.

Key words: Liver cancer, Tomography, Spectral CT imaging

中图分类号: 

  • R735.7
[1] Davila J A, EI-Serag H B. Cholangiocarcinoma: the “other” liver cancer on the rise[J]. Am J Gastroenterol, 2002, 97(12):3199-3200.
[2] Lim J H. Cholangiocarcinoma: morphologic classification according to growth pattern and imaging findings[J]. AJR Am J Roentgenol, 2003, 181(3):819-827.
[3] 高上达, 何以救, 林礼务, 等. 彩色多普勒超声在肝细胞癌与胆管细胞癌鉴别诊断中的价值[J]. 中华超声影像学杂志, 2005, 14(2): 124-127. GAO Shangda, HE Yijiu, LIN Liwu, et al. Value of color Doppler in differential diagnosis of hepatocellular carcinoma and cholangiocarcinoma [J]. Chinese Journal of Ultrasonography, 2005, 14(2):124-127.
[4] 徐桂军, 朱建友, 翟慎国, 等. 肝细胞癌与肝内周围型胆管细胞癌的螺旋CT动态增强与病理分析[J]. 中华肝胆外科杂志, 2010, 16(4): 253-256. XU Guijun, ZHU Jianyou, ZHAI Shenguo, et al. Dynamically enhanced patterns of hepatocellular carcinoma and intrahepatic peripheral cholangiocarcinoma by helical CT and pathological analysis[J]. Chinese Journal of Hepatobiliary Surgery, 2010, 16(4):253-256.
[5] 黄向阳, 苏丹柯, 康巍, 等. 肿块型胆管细胞癌的CT强化特点与病理特征对照研究[J].实用放射学, 2013, 29(7):1102-1104. HUANG Xiangyang, SU Danke, KANG Wei, et al. Correlation between dual-phase CT features and pathologic characteristicsof mass type cholangiocarcinoma[J]. Journal of Practical Radiology, 2013, 29(7):1102-1104.
[6] 孙典学, 李文华, 姜传武, 等. 肝内胆管细胞癌CT分型及临床意义[J]. 中国医学影像技术, 2009, 25(2): 257-259. SUN Dianxue, LI Wenhua, JIANG Chuanwu, et al. Clinical significance of CT classification of intrahepatic cholangiocarcinoma[J]. Chinese Journal of Medical Imaging Technlogy, 2009, 25(2):257-259.
[7] Lv P, Lin X Z, Chen K, et al. Spectral CT in patients with small HCC: investigation of image quality and diagnostic accuracy[J]. Eur Radiol, 2012, 22(10):2117-2124.
[8] 李明英, 张成琪, 邓凯. CT能谱成像对肺内良恶性肿块诊断的初步研究[J]. 中华放射学杂志, 2013, 47(5):410-413. LI Mingying, ZHANG Chengqi, DENG Kai. Preliminary study of spectral CT in benign and malignant lung lesions[J]. Chinese Journal of Radiology, 2013, 47(5):410-413.
[9] 王雪梅, 石华, 杨露露, 等. 能谱CT定量分析在鉴别诊断肺鳞癌与腺癌中的应用价值[J].宁夏医科大学学报, 2013, 35(4):415-418. WANG Xuemei, SHI Hua, YANG Lulu, et al. Value of spectral CT imaging in differentiating plumonary squamous cell carcinoma and adenocarcinoma[J]. Journal of Ningxia Medical University, 2013, 35(4):415-418.
[10] 郁义星, 林晓珠, 陈克敏, 等. CT能谱成像在鉴别小肝癌和小血管瘤中的价值[J]. 实用放射学杂志, 2012, 28(11): 1702-1706. YU Yixing, LIN Xiaozhu, CHEN Kemin, et al. The value of spectral CT imaging in differential diagnosis of small hepatocellular carcinoma and small hepatic hemangioma[J]. Journal of Practical Radiology, 2012, 28(11):1702-1706.
[11] Haaga J R, Lanzieri C F, Gilkeson R C. CT and MR imaging of the whole body[M]. 4th ed. St Louis: Mosby, 2003:1284-1286.
[12] Lee J K, Sagel S S, Stanley K J, et al. Computed body tomography with MRI correlation[M]. 3rd ed. Philadelphis: Lippineott Raven Publishers, 1998:728-734.
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