中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2011年
8期
731-735
,共5页
刘金刚%刘亚%李丽新%赵兴圣%周茂义%邵伟光%岳奎涛%张东雯%李文强%粘琦玉%张帅%曹会志
劉金剛%劉亞%李麗新%趙興聖%週茂義%邵偉光%嶽奎濤%張東雯%李文彊%粘琦玉%張帥%曹會誌
류금강%류아%리려신%조흥골%주무의%소위광%악규도%장동문%리문강%점기옥%장수%조회지
淋巴结%肿瘤转移%体层摄影术,X线计算机
淋巴結%腫瘤轉移%體層攝影術,X線計算機
림파결%종류전이%체층섭영술,X선계산궤
Lymph nodes%Neoplasm metastasis%Tomography,X-ray computed
目的 通过对淋巴瘤、肺腺癌、肺鳞癌及胆管癌的转移性淋巴结行能谱CT扫描,探讨能谱成像在鉴别不同肿瘤淋巴结转移性肿大中的应用价值.方法 回顾性分析2010年10月至12月间淋巴瘤3例(28个淋巴结)、肺腺癌5例(30个淋巴结)、肺鳞癌4例(24个淋巴结)及胆管癌2例(10个淋巴结)行能谱CT扫描,测量混合能量图像上各个淋巴结在不同能量水平下(40～140 keV,间隔10 keV)淋巴结的CT值及碘基图和水基图各个淋巴结的碘和水含量,分别对不同肿瘤转移性淋巴结在不同keV下淋巴结的CT值、碘和水含量进行方差分析和t检验.结果 观察肿大转移淋巴结的最佳对比噪声比对应的单能量水平是70 keV.70 keV下淋巴瘤、肺腺癌、肺鳞癌及胆管癌CT值分别(81.36±9.81)、(58.33±21.55)、(56.47±10.62)和(73.57±4.43)HU差异有统计学意义(F=17.29,P＜0.01),其中淋巴瘤与肺腺癌、肺鳞癌及肺鳞癌与胆管癌在CT值之间差异有统计学意义(P＜0.05),淋巴瘤与胆管癌及肺腺癌与胆管癌CT值差异有统计学意义(P＜0.05),肺腺癌与肺鳞癌CT值的差异未见统计学意义(P＞0.05).淋巴瘤、肺腺癌、肺鳞癌及胆管癌的碘含量分别为(1.93±0.05)、(1.16±0.15)、(1.25±0.21)和(1.44±0.04)g/L;淋巴瘤、肺腺癌、肺鳞癌及胆管癌的水含量分别为(1029.40±20.85)、(1024.98±11.19)、(1022.12±12.94)和(1030.87±10.10)g/L;肺腺癌与肺鳞癌的转移性淋巴结的碘含量之间差异未见统计学意义(t=1.77,P＞0.05),其他不同肿瘤转移性淋巴结的碘含量之间有统计学意义(P均＜0.05);各不同肿瘤转移性淋巴结的水含量之间未见统计学意义(P均＞0.05).结论 CT能谱成像通过应用碘含量及低能量下的CT值,对不同来源的转移性淋巴结的鉴别有较大意义,70 keV单能量图像显示肿大转移性淋巴结最清楚.
目的 通過對淋巴瘤、肺腺癌、肺鱗癌及膽管癌的轉移性淋巴結行能譜CT掃描,探討能譜成像在鑒彆不同腫瘤淋巴結轉移性腫大中的應用價值.方法 迴顧性分析2010年10月至12月間淋巴瘤3例(28箇淋巴結)、肺腺癌5例(30箇淋巴結)、肺鱗癌4例(24箇淋巴結)及膽管癌2例(10箇淋巴結)行能譜CT掃描,測量混閤能量圖像上各箇淋巴結在不同能量水平下(40～140 keV,間隔10 keV)淋巴結的CT值及碘基圖和水基圖各箇淋巴結的碘和水含量,分彆對不同腫瘤轉移性淋巴結在不同keV下淋巴結的CT值、碘和水含量進行方差分析和t檢驗.結果 觀察腫大轉移淋巴結的最佳對比譟聲比對應的單能量水平是70 keV.70 keV下淋巴瘤、肺腺癌、肺鱗癌及膽管癌CT值分彆(81.36±9.81)、(58.33±21.55)、(56.47±10.62)和(73.57±4.43)HU差異有統計學意義(F=17.29,P＜0.01),其中淋巴瘤與肺腺癌、肺鱗癌及肺鱗癌與膽管癌在CT值之間差異有統計學意義(P＜0.05),淋巴瘤與膽管癌及肺腺癌與膽管癌CT值差異有統計學意義(P＜0.05),肺腺癌與肺鱗癌CT值的差異未見統計學意義(P＞0.05).淋巴瘤、肺腺癌、肺鱗癌及膽管癌的碘含量分彆為(1.93±0.05)、(1.16±0.15)、(1.25±0.21)和(1.44±0.04)g/L;淋巴瘤、肺腺癌、肺鱗癌及膽管癌的水含量分彆為(1029.40±20.85)、(1024.98±11.19)、(1022.12±12.94)和(1030.87±10.10)g/L;肺腺癌與肺鱗癌的轉移性淋巴結的碘含量之間差異未見統計學意義(t=1.77,P＞0.05),其他不同腫瘤轉移性淋巴結的碘含量之間有統計學意義(P均＜0.05);各不同腫瘤轉移性淋巴結的水含量之間未見統計學意義(P均＞0.05).結論 CT能譜成像通過應用碘含量及低能量下的CT值,對不同來源的轉移性淋巴結的鑒彆有較大意義,70 keV單能量圖像顯示腫大轉移性淋巴結最清楚.
목적 통과대림파류、폐선암、폐린암급담관암적전이성림파결행능보CT소묘,탐토능보성상재감별불동종류림파결전이성종대중적응용개치.방법 회고성분석2010년10월지12월간림파류3례(28개림파결)、폐선암5례(30개림파결)、폐린암4례(24개림파결)급담관암2례(10개림파결)행능보CT소묘,측량혼합능량도상상각개림파결재불동능량수평하(40～140 keV,간격10 keV)림파결적CT치급전기도화수기도각개림파결적전화수함량,분별대불동종류전이성림파결재불동keV하림파결적CT치、전화수함량진행방차분석화t검험.결과 관찰종대전이림파결적최가대비조성비대응적단능량수평시70 keV.70 keV하림파류、폐선암、폐린암급담관암CT치분별(81.36±9.81)、(58.33±21.55)、(56.47±10.62)화(73.57±4.43)HU차이유통계학의의(F=17.29,P＜0.01),기중림파류여폐선암、폐린암급폐린암여담관암재CT치지간차이유통계학의의(P＜0.05),림파류여담관암급폐선암여담관암CT치차이유통계학의의(P＜0.05),폐선암여폐린암CT치적차이미견통계학의의(P＞0.05).림파류、폐선암、폐린암급담관암적전함량분별위(1.93±0.05)、(1.16±0.15)、(1.25±0.21)화(1.44±0.04)g/L;림파류、폐선암、폐린암급담관암적수함량분별위(1029.40±20.85)、(1024.98±11.19)、(1022.12±12.94)화(1030.87±10.10)g/L;폐선암여폐린암적전이성림파결적전함량지간차이미견통계학의의(t=1.77,P＞0.05),기타불동종류전이성림파결적전함량지간유통계학의의(P균＜0.05);각불동종류전이성림파결적수함량지간미견통계학의의(P균＞0.05).결론 CT능보성상통과응용전함량급저능량하적CT치,대불동래원적전이성림파결적감별유교대의의,70 keV단능량도상현시종대전이성림파결최청초.
Objective To investigate the feasibility of differentiating lymph node metastases of four types of primary tumors (lymphoma, lung adenocarcinoma, lung squamous cell carcinoma and cholangiocarcinoma) using gemstone spectral imaging (GSI) . Methods Three cases with lymphoma (28 lymph node), five cases with lung adenocarcinoma(30 lymph node), four cases with lung squamous cell carcinoma(24 lymph node) and two cases with cholangiocarcinoma( 10 lymph node) were evaluated by germstona spectra imaging CT scans. Imaging protocol included unenhanced conventional CT scan (120 kVp) ,enhanced GSI (80/140 kVp) on arterial phase and conventional CT scan (120 kVp) on portal phase. CT attenuation values of lymph nodes in the monochromatic images at 11 sets of keV levels (40-140 keV, 10 keV step) and the iodine and water contents of these lymph nodes were measured. All results were analyzed with ANOVA and t test. Results The optimal monochromatic level was 70 keV for the optimal contrast-noise ratio (CNR) of metastatic lymphadenopathy. The CT attenuation values of metastatic lymphadenopathy were (81.36 ±9. 81 ), (58.33 ± 21.55 ), (56. 47 ± 10.62) and (73. 57 ±4. 43 ) HU,respectively, at 70 keV( F = 17.29, P ＜0. 01 ). There were significant differences in CT attenuation values between lymphoma and lung adenocarcinoma, between lymphoma and lung squamous cell carcinoma and between lung squamous cell carcinoma and cholangiocarcinoma (P ＜ 0. 05 ). The differences in CT attenuation values were significant between cholangiocarcinoma and lung squamous cell carcinoma, between cholangiocarcinoma and lymphoma ( P ＜ 0. 05 ). There was no difference in CT attenuation values at all 11 sets of keV levels between lung squamous cell carcinoma and lung adenocarcinoma ( P ＞ 0. 05 ). The iodine contents of lymphoma, lung adenocarcinoma, lung squamous cell carcinoma and cholangiocarcinoma were ( 1. 93 ± 0. 04 ), ( 1.16 ± 0. 15 ), ( 1.25 ± 0. 21 ) and ( 1.44 ± 0. 04 ) g/L, respectively. The water contents of lymphoma, lung adenocarcinoma, lung squamous cell carcinoma and cholangiocarcinoma were (1029.40 ± 20. 85), (1024.98 ± 11.19), (1022.12 ± 12. 94) and (1030.87 ± 10.10) g/L,respectively. Except between lung squamous cell carcinoma and lung adenocarcinoma, the differences in the iodine contents of metastatic lymphadenopathy were significant among tumors ( P ＜ 0. 05 ). There was no difference in the water contents of metastatic lymphadenopathy among tumors ( P ＞ 0. 05 ). Conclusions Although CT spectral imaging fails to differentiate metastatic lymphadenopathy of lung adenocarcinoma and lung squamous cell carcinoma, it is also a promising method of distinguishing metastatic lymphadenopathy of malignant tumors by CT attenuation values in monochromatic images and iodine contents in material density images. The optimal monochromatic level was determined to be at 70 keV for providing the optimal CNR of metastatic lymphadenopathy.
