CAJ | 학술논문

目的初步探讨能谱CT单能量成像对不同肝脏肿瘤检出的影响.方法回顾性分析42例肝脏肿瘤患者(14例肝细胞癌、12例肝转移瘤、16例肝血管瘤)的临床和影像资料.患者均行CT能谱成像动脉期、门静脉期和静脉期扫描,获得140 kVp混合能量图像和70 keV单能量图像.对2组图像进行主观图像质量评分,测量肝实质噪声和肿瘤-肝实质的对比噪声比(CNR),2组间比较采用配对t检验.记录不同肿瘤在不同期相的病灶检出数量,采用百分数进行对比分析.结果在70 keV图像和140 kVp图像上,不同肿瘤在不同期相的图像质量评分分别为(4.30±0.25)和(3.63±0.22)分;肝实质噪声分别为(8.82±0.82)和(10.66±1.10);CNR分别为5.39和3.89,70 keV图像均优于140 kVp图像,差异均有统计学意义(P值均＜0.05).除动脉期肝转移瘤、动脉期肝血管瘤在2组图像上的检出率相同外,不同肿瘤在不同期相70 keV图像的病灶检出率(78%～100%)均高于140 kVp图像(65%～96%),以小病灶(＜1 cm)检出率增高最为明显(分别为57%～100%和14%～91%).结论能谱CT 70 keV单能量图像通过改善图像质量并增加肿瘤与肝实质的对比,有利于肝脏肿瘤的检出,对检出小病灶更敏感.
목적 초보탐토능보CT단능량성상대불동간장종류검출적영향.방법 회고성분석42례간장종류환자(14례간세포암、12례간전이류、16례간혈관류)적림상화영상자료.환자균행CT능보성상동맥기、문정맥기화정맥기소묘,획득140 kVp혼합능량도상화70 keV단능량도상.대2조도상진행주관도상질량평분,측량간실질조성화종류-간실질적대비조성비(CNR),2조간비교채용배대t검험.기록불동종류재불동기상적병조검출수량,채용백분수진행대비분석.결과 재70 keV도상화140 kVp도상상,불동종류재불동기상적도상질량평분분별위(4.30±0.25)화(3.63±0.22)분;간실질조성분별위(8.82±0.82)화(10.66±1.10);CNR분별위5.39화3.89,70 keV도상균우우140 kVp도상,차이균유통계학의의(P치균＜0.05).제동맥기간전이류、동맥기간혈관류재2조도상상적검출솔상동외,불동종류재불동기상70 keV도상적병조검출솔(78%～100%)균고우140 kVp도상(65%～96%),이소병조(＜1 cm)검출솔증고최위명현(분별위57%～100%화14%～91%).결론 능보CT 70 keV단능량도상통과개선도상질량병증가종류여간실질적대비,유리우간장종류적검출,대검출소병조경민감.
Objective To evaluate the effect of spectral CT monochromatic imaging on the detection of hepatic tumors. Methods Forty-two patients with hepatic tumors (14 patients with hepatocellular carcinoma, 12 patients with metastatic tumor, 16 patients with hemangioma) underwent CT spectral imaging. During arterial phase, portal phase and venous phase, 140 kVp polychromatic images and 70 keV monochromatic images were obtained. Paired-sample t tests were used to compare the image quality score,liver noise and tumor-to-liver contrast-to-noise ratio (CNR) between the two image data sets. The detection rates of various tumors during each phase were compared. Results The image quality scores of various tumors during three phases were (4. 30 ± 0. 25) and (3.63 ± 0. 22) averagely for the 70 keV and 140 kVp images. The liver noises were (8. 82 ± 0. 82) and ( 10. 66 ± 1.10) , and the CNRs were 5.39 and 3. 89,respectively. The image quality score, the liver noise and the CNR of 70 keV images were significantly greater than those of 140 kVp images (P ＜0. 05 ). The detection rates of various tumors during each phase were higher with 70 keV images (78％-100％) than with 140 kVp images (65％-96％), except the hepatic metastatic tumors and the hepatic hemangiomas during the arterial phase. The detection rate was more increased for the small lesions less than 1 cm (57％-100％ vs. 14％-91％ ). Conclusion By substantially improving the image quality and increasing the tumor-to-liver conspicuity, the 70 keV monochromatic imaging of spectral CT improves the detection of hepatic tumors and is more sensitive for the detection of small lesions.