双源CT能谱成像在局灶性结节增生和肝癌的诊断与鉴别诊断中的应用价值

Application of Spectral Imaging of Dual-source CT in Diagnosis and Differential Diagnosis of Hepatocellular Carcinoma and Focal Nodular Hyperplasia

目的探讨双源CT能谱成像在局灶性结节增生(FNH)和肝癌的诊断与鉴别诊断中的应用价值。方法回顾性分析52例经病理证实的肝脏富血供病变患者(肝癌35例,FNH 17例)的双源CT能谱成像(动脉期及门脉期)的系列图像。测量病灶及肝组织等的能谱参数;并计算两期不同能量水平下病灶-肝组织对比噪声比(CNR)、标准化碘浓度(NIC)及病灶与肝组织碘浓度比值(ICRLN)。结果动脉期:FNH与肝癌在40~120keV的CNR随着能量的升高逐渐减少,均在120keV具有最佳的CNR;NIC及ICRLN值FNH均显著高于肝癌(P<0.05)。门脉期:在40~120keV,FNH的CNR逐渐减少,在40keV具有最佳的CNR,而肝癌则是先增加再逐渐减少,在80keV具有最佳的CNR;NIC及ICRLN值FNH均显著高于肝癌(P<0.05)。结论双源CT能谱成像可提高FNH及肝癌的检出及诊断准确率,具有较大的临床价值。

Objective To explore the values of spectral imaging of dual-source CT in diagnosis and differential diagnosis of hepatocellular carcinoma and focal nodular hyperplasia（FNH）. Meth- ods Serial spectral images of arterial and portal venous phase dual-source CT were retrospective- ly analyzed in 52 patients with pathology-confirmed hepatic lesions with rich blood supply（35 ca- ses of hepatocellular carcinoma and 17 cases of FNH）. The spectral parameters of normal hepatic tissues and hepatic lesions were measured,and the normalized iodine concentration（NIC）,lesion- liver contrast-to-noise ratio（CNR） and iodine concentration ratio of lesion-normal liver（ICRLN） at different energy levels were determined during the portal venous phase and arterial phase. Re- sults Arterial phase.FNH and hepatocellular carcinoma in 40--120 keV CNR as energy increases gradually reduce,in the 120 keV has the best CNR; NIC and ICRLN values FNH were signifi- cantly higher than that of hepatocellular carcinoma （P^0.05）. Portal phase： in 40--120 keV, CNR of FNH gradually reduce,in 40 keV has the best CNR,and hepatocellular carcinoma is increased first,then gradually reduce in the 80 keV has the best CNR;NIC and ICRLN values FNH were significantly higher than that of hepatocellular carcinoma （P〈 0. 05）. Conclusion The spectral imaging of dual-source CT can improve sis of hepatocellular carcinoma and FNH. the detection rate and accuracy rate in the diagn.