不同病理类型膀胱癌能谱CT成像特点的临床研究

The Value of Gemstone Spectral Imaging in the Diagnosis of Bladder Cancer with Different Pathological Types

目的:探讨不同病理类型膀胱癌能谱CT成像特点。方法:20例病理证实的膀胱癌患者接受了能谱CT检查(男性18人,女性2人,年龄44～87岁,平均年龄64岁)。对病灶部位进行动脉和静脉期双期能谱扫描。根据病理类型的不同将患者分为浸润性膀胱癌和乳头状膀胱癌两组,每组各10例。分别测量两组图像中在不同keV单能量水平下病灶的CT值,碘基值,水基值及有效Z值。将两组所得结果进行对比分析。结果:动脉期两组病灶不同keV单能量水平下的CT值,碘基值,水基值及有效Z值间均不存在显著的统计学差异;静脉期两组病灶在40～80keV单能量水平下的CT值间具有显著的统计学差异,浸润性膀胱癌的CT值高于乳头状癌;静脉期两组碘基值间具有显著的统计学差异(P<0.05)。静脉期两组病灶水基值及有效Z值间无显著统计学差异。结论:不同病理类型膀胱癌具有不同的能谱CT成像特点,有望为术前治疗方案的制定提供一定的依据。

Purpose： To assess the Gemstone Spectral Imaging （GSI） characteristics of different pathological types of bladder cancer. Methods： Twenty cases of bladder cancer which were pathologically confirmed were collected and dual phase scan （arterial phase and venous phase） with GSI mode by Discovery CT750 HD were undergone. One hundred and one sets of monochromatic images were generated. All cases were analyzed with GSI viewer. The different parameters of CT spectral imaging were measured, including CT value from 40keV to 140keV, the value of iodine and water material and Effective-Z. Twenty cases were grouped into bladder papilloma or invasive cancer. All parameters were compared between the two groups. For statistical analysis, student＇s t tests were used. Results： In arterial phase, there was no significant difference between bladder papilloma cancer and invasive cancer in all parameters （P〉0.05）. In venous phase, the difference was found in the CT value from 40 keV to 80 keV between two groups. There was significant difference in the value of iodine material between two groups （t=-2.143, P=0.041）. There was no difference in the value of water material and Effective-Z between bladder papilloma cancer and invasive cancer group （P〉0.05）. Conclusion： Different pathological types of bladder cancer have a different GSI CT imaging characteristics, they are helpful to make the clinical preoperative therapy proposal.