CAJ | 학술논문

目的：评价肝癌肝动脉化疗栓塞（TACE）术后双源CT虚拟平扫的图像质量以及去除栓塞区域碘油的能力。方法：对40例肝癌TACE术后患者先行常规腹部平扫（TNC），然后静脉注射对比剂行双能量动脉期、门静脉期增强扫描，之后采用肝脏虚拟平扫后处理软件Liver VNC对双能量强化图像进行处理，得到 VNC 图像，以TNC 图像为标准，评价VNC图像的图像质量及VNC去除碘油的能力，比较图像的信噪比（SNR）、对比信噪比（CNR）、碘油沉积缺损区及病灶周边区CT值并进行统计学分析。结果：VNC具有很强的去除碘油的能力，对于碘油沉积患者，VNC较TNC在图像质量上有所下降，碘油沉积缺损区的CT值VNC较TNC低，差异有统计学意义（TNC动脉期CT 值＝54．4±19．1，VNC-CT 值＝44．8±12．9，P＜0．05；TNC门静脉期CT值＝54．4±19．1，VNC-CT值＝45．3±13．4，P＜0．05），病灶周边区的CT 值VNC与TNC差异无统计学意义（TNC动脉期CT值＝56．4±7．6，VNC-CT值＝55．1±7．8，P＞0．05；TNC门静脉期CT值＝56．4±7．6，VNC-CT值＝58．3±8．2，P＞0．05），病灶的动脉期VNC 与门静脉期VNC 的CT 值差异无统计学意义（碘油沉积缺损区动脉期 CT 值＝44．8±12．9，门静脉期 CT 值＝45．3±13．4，P＞0．05；病灶周边区动脉期 CT 值＝55．1±7．8，门静脉期CT值＝58．3±8．2，P＞0．05）。结论：对于较少碘油沉积的病例，VNC能基本满足诊断需求，对于肝癌TACE术后病灶，VNC对病灶周边区的显示好于病灶内。
목적：평개간암간동맥화료전새（TACE）술후쌍원CT허의평소적도상질량이급거제전새구역전유적능력。방법：대40례간암TACE술후환자선행상규복부평소（TNC），연후정맥주사대비제행쌍능량동맥기、문정맥기증강소묘，지후채용간장허의평소후처리연건Liver VNC대쌍능량강화도상진행처리，득도 VNC 도상，이TNC 도상위표준，평개VNC도상적도상질량급VNC거제전유적능력，비교도상적신조비（SNR）、대비신조비（CNR）、전유침적결손구급병조주변구CT치병진행통계학분석。결과：VNC구유흔강적거제전유적능력，대우전유침적환자，VNC교TNC재도상질량상유소하강，전유침적결손구적CT치VNC교TNC저，차이유통계학의의（TNC동맥기CT 치＝54．4±19．1，VNC-CT 치＝44．8±12．9，P＜0．05；TNC문정맥기CT치＝54．4±19．1，VNC-CT치＝45．3±13．4，P＜0．05），병조주변구적CT 치VNC여TNC차이무통계학의의（TNC동맥기CT치＝56．4±7．6，VNC-CT치＝55．1±7．8，P＞0．05；TNC문정맥기CT치＝56．4±7．6，VNC-CT치＝58．3±8．2，P＞0．05），병조적동맥기VNC 여문정맥기VNC 적CT 치차이무통계학의의（전유침적결손구동맥기 CT 치＝44．8±12．9，문정맥기 CT 치＝45．3±13．4，P＞0．05；병조주변구동맥기 CT 치＝55．1±7．8，문정맥기CT치＝58．3±8．2，P＞0．05）。결론：대우교소전유침적적병례，VNC능기본만족진단수구，대우간암TACE술후병조，VNC대병조주변구적현시호우병조내。
Objective:To assess the image quality of virtual non-contrast (VNC)images and the ability of iodized oil removal in the embolization zone of iodized oil in hepatocellular carcinoma (HCC)patients with transcatheter arterial che-moembolization (TACE)on VNC images by dual energy CT.Methods:Forty HCC patients with TACE were enrolled.Dual-energy CT was performed in both arterial and portal phases.VNC was generated from dual energy mode CT scans.The true non-contrast (TNC)images were used as standard.The mean image quality of both SNR (signal-to-noise ratio)and CNR (contrast-to-noise ratio)and the ability of iodized oil removal (the average CT value of iodized oil in both deposit defect area and perifocal area)of VNC were compared with TNC using T test.Results:VNC possesses the powerful ability of removing iodized oil.For patients of iodized oil deposit,compared with TNC,the image quality of VNC was poorer.A significant difference existed in average CT value of iodized oil deposit defect area(arterial phase CTTNC= 54.4±19.1,CTVNC=44.8±12.9,P<0.05;portal phase CTTNC= 54.4±19.1,CTVNC= 45.3±13.4,P<0.05).No significant statistical difference existed in average CT value of perifocal area (arterial phase CTTNC= 5 6 .4 ± 7 .6 ,CTVNC= 5 5 .1 ± 7 .8 ,P>0.05;portal phase CTTNC= 56.4±7.6,CTVNC= 58.3±8.2,P>0.05).No significant statistical difference in average CT value between arterial and portal phase of VNC (iodized oil deposit defect area CTa= 44.8±12.9,CTp= 45.3±13.4,P>0.05;perifocal area CTa= 55.1±7.8,CTp= 58.3±8.2,P>0.05).Conclusion:The image quality of VNC images can meet the diagnostic needs in cases of less iodized oil accumulation,it could better differentiate HCC of perifocal areas from that ofintralesional areas after TACE.