中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2013年
11期
997-1001
,共5页
刘学玲%周建军%陈宏伟%胡晓云%廖蕾
劉學玲%週建軍%陳宏偉%鬍曉雲%廖蕾
류학령%주건군%진굉위%호효운%료뢰
肾肿瘤%体层摄影术,X线计算机
腎腫瘤%體層攝影術,X線計算機
신종류%체층섭영술,X선계산궤
Renal neoplasms%Tomography,X-ray computed
目的 探讨双能CT双期增强扫描诊断小透明细胞肾癌的最佳期相和最佳管电压条件.方法 回顾性分析27个经手术病理证实的小透明细胞肾癌病灶(直径≤3cm)术前双能量皮髓早期及延迟期扫描资料,以病理结果为标准,将图像(80 kV、140 kV及融合120 kV)对小透明细胞肾癌的显示清晰度进行评分,采用Wilcoxon和Friedman秩和检验比较各期不同管电压条件下图像显示病变的清晰度；采用单因素方差分析比较同一期相三组管电压条件下病灶CT值、噪声值、对比噪声比,以及病灶在皮髓早期与延迟期的CT值变化值.结果 在三组管电压条件下(80 kV、140 kV和融合120 kV),图像在皮髓早期对病变显示清晰度的得分分别为(3.30 ±0.87)、(2.81±0.92)和(3.11±0.85)分,延迟期分别为(3.70±0.54)、(3.30±0.82)和(3.52±0.64)分,延迟期对病变的显示清晰度均高于皮髓早期(Z值分别为-2.296、-2.446和-2.392,P值均＜0.05).无论在皮髓早期或延迟期,80 kV图像病灶CT值[分别为(302±80)和(152±31)HU]、噪声值[分别为(16.2±2.2)和(16.4±2.7)HU]和CNR值均最高[分别为(4.1±3.4)和(4.7±1.7)],和其他管电压下结果差异有统计学意义(P值均＜0.05).80 kV、140 kV和融合120 kV条件下,病灶在皮髓早期和延迟期的CT值变化值分别为(150±76)、(72 ±33)和(96 ±46) HU,差异有统计学意义(F=4.541,P＜0.01).结论 延迟期扫描有利于小透明细胞肾癌的显示；80 kV图像较140 kV和融合120 kV图像更有利于小透明细胞肾癌的显示和定性.
目的 探討雙能CT雙期增彊掃描診斷小透明細胞腎癌的最佳期相和最佳管電壓條件.方法 迴顧性分析27箇經手術病理證實的小透明細胞腎癌病竈(直徑≤3cm)術前雙能量皮髓早期及延遲期掃描資料,以病理結果為標準,將圖像(80 kV、140 kV及融閤120 kV)對小透明細胞腎癌的顯示清晰度進行評分,採用Wilcoxon和Friedman秩和檢驗比較各期不同管電壓條件下圖像顯示病變的清晰度；採用單因素方差分析比較同一期相三組管電壓條件下病竈CT值、譟聲值、對比譟聲比,以及病竈在皮髓早期與延遲期的CT值變化值.結果 在三組管電壓條件下(80 kV、140 kV和融閤120 kV),圖像在皮髓早期對病變顯示清晰度的得分分彆為(3.30 ±0.87)、(2.81±0.92)和(3.11±0.85)分,延遲期分彆為(3.70±0.54)、(3.30±0.82)和(3.52±0.64)分,延遲期對病變的顯示清晰度均高于皮髓早期(Z值分彆為-2.296、-2.446和-2.392,P值均＜0.05).無論在皮髓早期或延遲期,80 kV圖像病竈CT值[分彆為(302±80)和(152±31)HU]、譟聲值[分彆為(16.2±2.2)和(16.4±2.7)HU]和CNR值均最高[分彆為(4.1±3.4)和(4.7±1.7)],和其他管電壓下結果差異有統計學意義(P值均＜0.05).80 kV、140 kV和融閤120 kV條件下,病竈在皮髓早期和延遲期的CT值變化值分彆為(150±76)、(72 ±33)和(96 ±46) HU,差異有統計學意義(F=4.541,P＜0.01).結論 延遲期掃描有利于小透明細胞腎癌的顯示；80 kV圖像較140 kV和融閤120 kV圖像更有利于小透明細胞腎癌的顯示和定性.
목적 탐토쌍능CT쌍기증강소묘진단소투명세포신암적최가기상화최가관전압조건.방법 회고성분석27개경수술병리증실적소투명세포신암병조(직경≤3cm)술전쌍능량피수조기급연지기소묘자료,이병리결과위표준,장도상(80 kV、140 kV급융합120 kV)대소투명세포신암적현시청석도진행평분,채용Wilcoxon화Friedman질화검험비교각기불동관전압조건하도상현시병변적청석도；채용단인소방차분석비교동일기상삼조관전압조건하병조CT치、조성치、대비조성비,이급병조재피수조기여연지기적CT치변화치.결과 재삼조관전압조건하(80 kV、140 kV화융합120 kV),도상재피수조기대병변현시청석도적득분분별위(3.30 ±0.87)、(2.81±0.92)화(3.11±0.85)분,연지기분별위(3.70±0.54)、(3.30±0.82)화(3.52±0.64)분,연지기대병변적현시청석도균고우피수조기(Z치분별위-2.296、-2.446화-2.392,P치균＜0.05).무론재피수조기혹연지기,80 kV도상병조CT치[분별위(302±80)화(152±31)HU]、조성치[분별위(16.2±2.2)화(16.4±2.7)HU]화CNR치균최고[분별위(4.1±3.4)화(4.7±1.7)],화기타관전압하결과차이유통계학의의(P치균＜0.05).80 kV、140 kV화융합120 kV조건하,병조재피수조기화연지기적CT치변화치분별위(150±76)、(72 ±33)화(96 ±46) HU,차이유통계학의의(F=4.541,P＜0.01).결론 연지기소묘유리우소투명세포신암적현시；80 kV도상교140 kV화융합120 kV도상경유리우소투명세포신암적현시화정성.
Objective To detect the best phase and best tube voltage for the diagnosis of small (diameter ≤ 3 cm) clear cell renal cell carcinoma with dual-energy dual-phase CT.Methods Image manifestations of 27 patients with small (diameter ≤ 3 cm) ccRCCs confirmed by pathology were retrospectively analyzed.All subjects underwent dual-energy biphase (early corticomedullary and delayed phase) scan preoperatively.Two senior radiologists analyzed the images in consensus.The definition of images in different phases and with different tube voltage was classified into 4 levels and was compared by Wilcoxon and Friedman test.The attenuation of the lesions and the adjacent renal parenchyma,the SD value of the anterior abdomen fat were measured.The contrast noise ratio (CNR),lesion kidney ratio (LKR) and the early corticomedullary phase and delayed phase value were calculated.They were all compared with oneway ANOVA.Results The score of definition of lesions in early corticomedullary phase at 80 kV,140 kV and average-weighted 120 kV were 3.30 ± 0.87,2.81 ± 0.92 and 3.11 ± 0.85,respectively,which in delayed phase were 3.70 ±0.54,3.30 ±0.82 and 3.52 ±0.64,respectively.Definition of lesions was better in delayed phase than that in early corticomedullary phase (Z =-2.296,-2.446 and-2.392,respectively; P ＜ 0.05).Either in early corticomedullary phase or in delayed phase,CT value,noise value and CNR were the highest on 80 kV images,which were(302 ± 80)HU,(16.2 ± 2.2) and (4.1 ± 3.4) in corticomedullary phase and (152 ± 31) HU,(16.4 ± 2.7) HU,and (4.7 ± 1.7) in delayed phase.The change of lesion attenuation between early corticomedullary phase and delayed phase on 80 kV,140 kV and averageweighted 120 kV images were (150 ± 76),(72 ± 33) and (96 ± 46) HU,respectively.There was significant difference among the three groups (F =4.541,P ＜ 0.01).Conclusions Delayed phase scan is in favor of small clear cell renal cell carcinoma display.80 kV images are the best for detecting and qualitation of small clear cell renal cell carcinoma when compared with 140 kV and the average-weighted 120 kV images.
