CAJ | 학술논문

目的：探讨能谱CT单能量成像对甲状腺微小癌的检出率和物质分离技术对微小癌的诊断价值。方法收集经手术病理证实的49例甲状腺微小癌患者，采用能谱CT（Discovery CT750 HD）进行GSI单能模式平扫及增强扫描，测量其碘浓度和碘浓度比，并与病理结果对照。结果（1）微小癌的最佳 keV 值为（61．53±5．21）（动脉期）和（60．32±4．14）（静脉期）；最佳单能量下，微小癌的检出率为77．05％；（2）微小癌的碘浓度分别为（6．91±3．90）（平扫）、（11．45±5．08）（动脉期）和（19．54±6．38）（静脉期），其碘浓度比分别为（0．20±0．10）（动脉期）、（0．54±0．20）（静脉期），动脉期和静脉期微小癌组的碘浓度和碘浓度低于良性小结节组和正常甲状腺组（ P＜0．05）；能谱C T对微小癌的诊断准确率为62．30％～80．85％。结论能谱C T 最佳单能量技术能提高微小癌的检出率，基物质浓度测定对微小癌的准确诊断具有重要价值。
목적：탐토능보CT단능량성상대갑상선미소암적검출솔화물질분리기술대미소암적진단개치。방법수집경수술병리증실적49례갑상선미소암환자，채용능보CT（Discovery CT750 HD）진행GSI단능모식평소급증강소묘，측량기전농도화전농도비，병여병리결과대조。결과（1）미소암적최가 keV 치위（61．53±5．21）（동맥기）화（60．32±4．14）（정맥기）；최가단능량하，미소암적검출솔위77．05％；（2）미소암적전농도분별위（6．91±3．90）（평소）、（11．45±5．08）（동맥기）화（19．54±6．38）（정맥기），기전농도비분별위（0．20±0．10）（동맥기）、（0．54±0．20）（정맥기），동맥기화정맥기미소암조적전농도화전농도저우량성소결절조화정상갑상선조（ P＜0．05）；능보C T대미소암적진단준학솔위62．30％～80．85％。결론능보C T 최가단능량기술능제고미소암적검출솔，기물질농도측정대미소암적준학진단구유중요개치。
Objective To investigate the diagnostic value of spectral CT monochromatic imaging and iodine-based material decomposition technique for thyroid micro-carcinoma . Methods Totally 49 patients with thyroid micro-carcinoma (61 lesions) underwent CT imaging with GSI mode . The iodine concentration of micro-carcinoma ,normalized iodine concentration (NIC) of each phase was calculated . All results were analyzed by comparing with pathology . Results (1) The optimal keV in arterial and venous phase of demonstrating small thyroid carcinoma was (61 .53 ± 5 .21) keV and (60 .32 ± 4 .14) keV , respectively . (2 ) The iodine concentration of micro-carcinoma was (6 .91 ± 3 .90 ) (non-contrast ) , (11 .45 ± 5 .08)(arterial phase ,AP)and(19 .54 ± 6 .38)(venous phase ,VP)(100 μg/cc) ,NIC of micro-car-cinoma was (0 .20 ± 0 .10)(AP) ,(0 .54 ± 0 .20)(VP) ,respectively . There was significant difference in comparison between any two groups on iodine concentration and NIC both in AP and VP (all of them P<0 .05) . (3)Compared to the pathologic results ,the accuracy of diagnosing micro-carcinoma by spec-tral CT was 62 .30% ~80 .85% . Conclusion Spectral CT imaging is a promising method to detect and di-agnose the thyroid micro-carcinoma .