能谱CT在肝细胞癌与肝内肿块型胆管细胞癌鉴别诊断中的应用价值

Application value of spectral CT imaging in differential diagnosis of hepatocellular carcinoma and hepatic mass-type cholangiocarcinoma

目的探讨能谱CT在肝细胞癌与肝内肿块型胆管细胞癌鉴别诊断中的应用价值。方法行能谱CT扫描并经病理证实的肝癌患者34例(肝细胞癌20例、肝内肿块型胆管细胞癌14例),通过能谱分析软件,获取肿块内感兴趣区的碘基图、水基图及101组单能量图像,分析单能量55 Kev下对应的碘含量、水含量、能谱曲线及标准化后碘含量。用独立样本t检验分析上述参数。结果肝细胞癌的碘含量、能谱曲线斜率、标准化后碘含量分别为(12.84±2.38)、(1.58±0.24)、(0.15±0.05)μg/cm3,肝内肿块型胆管细胞癌分别为(10.71±3.01)、(1.34±0.32)、(0.12±0.34)μg/cm3。肝细胞癌与肝内肿块型胆管细胞癌的碘含量、能谱曲线斜率、标准化后碘含量差异均有统计学意义(P<0.05)。肝细胞癌与肝内肿块型胆管细胞癌的水含量分别为(1041.05±6.47)、(1 038.74±8.54)mg/cm3,差异无统计学意义(P>0.05)。结论能谱CT成像及多参数分析,对肝细胞癌与肝内肿块型胆管细胞癌鉴别诊断中有一定价值。

Objective To explore the application value of spectral CT imaging in the differential diagnosis of hepatocel- hilar carcinoma and hepatic mass-type cholangiocarcinoma. Methods A total of 34 liver cancer cases, including 20 hepatocellular carcinoma and 14 hepatic mass-type cholangiocarcinoma, underwent spectral CT scan. Iodine concentra- tion, water concentration and 101 sets of monochromatic images were generated with gemstone spectral imaging post- processing software. The iodine concentration, water concentration, spectrum energy curve and normalized iodine con- centration were measured at the monochromatic energy 55 Kev. The results were analyzed with independent samples t test. Results In hepatocellular carcinoma, the iodine concentration, spectrum energy curve and normalized iodine concentration were （ 12.84±2.38 ）, （ 1.58±0.24） and （0.15 ±0.05 ） μg/cm^3 ; while in cholangiocarcinoma, those were （ 10.71±3.01）, （ 1. 34 ±0.32 ） and （ 0.12±0.34 ） μg/cm^3. There were significant differences between those indexes （P 〈 0.05）. The water concentration in hepatocellular carcinoma and cholangiocarcinoma were （ 1 041.05±6.47） and （ 1038.74±8.54） mg/cm^3, respectively, exhibiting no significant difference （ P 〉 0.05 ）. Conclusion Spectral CT is helpful for the differential diagnosis of hepatocellular carcinoma and hepatic mass-type cholangiocarcinoma.