富血供肝脏转移瘤与肝细胞肝癌的能谱CT成像定量分析

doi:10.6040/j.issn.1671-7554.0.2016.058

摘要/Abstract

摘要： 目的探讨能谱CT成像定量分析在富血供肝脏转移瘤(HVHM)与肝细胞肝癌(HCC)鉴别诊断中的临床应用价值。方法分析行能谱CT扫描的肝脏恶性肿瘤患者47例,分为HVHM组(n=20)和HCC组(n=27),获取动脉期、门静脉期单能量图像,以及碘基图、水基图,测量病灶边缘明显强化区域、正常肝组织和腹主动脉的能谱参数,并计算标准化碘浓度(NIC)、病灶与正常肝组织碘浓度比值(LNR)、病灶动静脉期碘浓度差(ICD)及能谱曲线斜率,对上述参数行独立样本t检验和ROC曲线分析。结果动脉期HVHM组和HCC组的NIC、LNR、能谱曲线斜率无明显差异(P>0.05)。门静脉期HVHM组和HCC组NIC、LNR及能谱曲线斜率差异有统计学意义(P<0.05):两组门静脉期NIC分别为0.59±0.08、0.45±0.10;LNR分别为1.17±0.22、0.92±0.16;能谱曲线斜率分别为1.85±0.49、1.18±0.34。HVHM组和HCC组ICD参数分别为(0.54±0.39)g/L、(0.45±0.39)g/L,差异无统计学意义(P>0.05)。水(碘)浓度在动脉期、门静脉期差异无统计学意义(P>0.05)。门静脉期能谱曲线斜率对HVHM组和HCC组的鉴别诊断效能最高。结论 HVHM和HCC在门静脉期的能谱CT特征性物质含量及能谱曲线具有明显差异,CT能谱成像为HVHM和HCC鉴别诊断提供了一种多参数定量分析方法。

关键词: 肝脏转移瘤, 富血供, 能谱成像, X线计算机, 肝细胞肝癌, 体层摄影术, 定量分析

Abstract: Objective To evaluate the value of the spectral CT quantitative analysis in the differential diagnosis of hypervascular hepatic metastasis(HVHM)and hepatocellular carcinoma(HCC). Methods A total of 47 patients with hepatic malignant tumors undergoing spectral CT scan were divided into HVHM group(n=20)and HCC group(n=27). The monochromatic image sets, iodine-based material decomposition images and water-based material decomposition images were obtained, and the spectral parameters of lesions, normal hepatic tissues and aorta were measured. Then the normalized iodine concentrations(NIC), lesion-normal parenchyma iodine concentration ratio(LNR), iodine concentration difference(ICD)between the arterial phase and portal venous phase, and the slope of spectral curve were calculated. Independent samples t test and ROC were applied to analyze the quantitative parameters. Results Differences of the NIC, LNR and slope of spectral curve were not statistically significant(P>0.05)during arterial phase. Statistically significant differences of the NIC, LNR and slope of spectral curve were found between the HVHM 山东大学学报 (医学版)54卷7期 -岳倩倩,等.富血供肝脏转移瘤与肝细胞肝癌的能谱CT成像定量分析 \=-group and the HCC group(P<0.05)during portal venous phase: NIC=0.59±0.08, 0.45±0.10; LNR=1.17±0.22, 0.92±0.16; the slopes of spectral curve=1.85±0.49, 1.18±0.34, respectively. Differences of ICD between the HVHM group and the HCC group were not statistically significant(P>0.05), and ICD were(0.54±0.39)g/L,(0.45±0.39)g/L, respectively. Differences of water(iodine)concentration in arterial and portal venous phase between the lesions were not statistically significant(P>0.05). The slope of spectral curve in the portal venous phase had the highest diagnostic efficiency in differentiating HVHM from HCC. Conclusions HVHM and HCC have different spectral characteristic parameters and spectral curves during portal venous phase. Spectral CT imaging provides a new multi-parameter quantitative analysis imaging method for differentiating HVHM and HCC.

Key words: Hepatic metastasis, Hypervascularity, Tomography, X-ray computed, Quantitative analysis, Spectral imaging, Hepatocellular carcinoma

中图分类号:

R445

岳倩倩,王新怡,杨志强,姜舒. 富血供肝脏转移瘤与肝细胞肝癌的能谱CT成像定量分析[J]. 山东大学学报（医学版）, 2016, 54(7): 50-55.

YUE Qianqian, WANG Xinyi, YANG Zhiqiang, JIANG Shu. Quantitative analysis of spectral CT imaging on hypervascular hepatic metastasis and hepatocellular carcinoma[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(7): 50-55.

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