CAJ | 학술논문

目的：探讨 CT 能谱成像在鉴别胰腺癌与肿块型胰腺炎中的价值，提高术前鉴别诊断准确率。资料与方法回顾性分析经能谱 CT 检查并经手术病理证实的62例胰腺癌患者（胰腺癌组）和30例肿块型胰腺炎患者（胰腺炎组）的临床资料，在动脉期和门静脉期40~140 keV 单能量下（间隔10 keV），分别测量和比较两组病灶的平均 CT 值、碘浓度以及能谱曲线的差异。结果在动脉期和门静脉期的40~140 keV单能量下，胰腺炎组的平均 CT 值均大于胰腺癌组，差异均有统计学意义（t 动脉期=－7.349~－4.810，P<0.05；t 门静脉期=－6.760~－5.496，P<0.05）。胰腺炎组与胰腺癌组的能谱曲线有明显的差别，在40~70 keV 低能量之间差异明显。胰腺癌组在动脉期和门静脉期的碘浓度均低于胰腺炎组，差异有统计学意义（t 动脉期=－28.577， P<0.05；t 门静脉期=－28.451，P<0.05）。结论通过 CT 能谱成像技术测量不同单能量下 CT 值、能谱曲线以及碘浓度可以鉴别胰腺癌和肿块型胰腺炎。
목적：탐토 CT 능보성상재감별이선암여종괴형이선염중적개치，제고술전감별진단준학솔。자료여방법회고성분석경능보 CT 검사병경수술병리증실적62례이선암환자（이선암조）화30례종괴형이선염환자（이선염조）적림상자료，재동맥기화문정맥기40~140 keV 단능량하（간격10 keV），분별측량화비교량조병조적평균 CT 치、전농도이급능보곡선적차이。결과재동맥기화문정맥기적40~140 keV단능량하，이선염조적평균 CT 치균대우이선암조，차이균유통계학의의（t 동맥기=－7.349~－4.810，P<0.05；t 문정맥기=－6.760~－5.496，P<0.05）。이선염조여이선암조적능보곡선유명현적차별，재40~70 keV 저능량지간차이명현。이선암조재동맥기화문정맥기적전농도균저우이선염조，차이유통계학의의（t 동맥기=－28.577， P<0.05；t 문정맥기=－28.451，P<0.05）。결론통과 CT 능보성상기술측량불동단능량하 CT 치、능보곡선이급전농도가이감별이선암화종괴형이선염。
Purpose To explore the value of spectral CT imaging in differentiating pancreatic carcinoma and mass-forming pancreatitis, and to improve the preoperative diagnosis accuracy. Materials and Methods The dual-phase spectral CT imaging data in patients with pathology-proven pancreatic carcinoma (n=62) and mass-forming pancreatitis (n=30) were retrospectively analyzed. At 40-140 keV (with 10 keV increment), the mean CT values, energy spectrum curves and iodine concentrations were measured and compared between pancreatic carcinoma and mass-forming pancreatitis in arterial phase and portal venous phase. Results The mean CT values of mass-forming pancreatitis at 40-140 keV were higher than pancreatic carcinoma in both arterial phase and portal venous phase with significant difference (t= -7.349- -4.810, P<0.05; t= -6.760- -5.496, P<0.05). The energy spectrum curves were significantly different between pancreatic carcinoma and mass-forming focal pancreatitis, especially at 40-70 keV. The iodine concentrations of pancreatic carcinoma were lower than mass-forming pancreatitis in arterial phase and portal venous phase with significant difference (t=-28.577, P<0.05; t= -28.451, P<0.05). Conclusion Pancreatic carcinoma and mass-forming pancreatitis can be differentiated by measuring the CT value at different energies, energy spectrum curves and iodine concentrations.