双源CT能谱成像在鉴别肾上腺无功能腺瘤与肾上腺转移瘤中的价值

Clinical Application of Dual-Source CT Spectral Imaging in Differentiating Non-Functioning Adrenal Adenoma from Adrenal Metastases

目的探讨双源CT虚拟平扫技术及碘含量测定技术在鉴别肾上腺良恶性病变中的价值。方法搜集行肾上腺CT扫描者40例(共40个肾上腺结节),其中24个结节为无功能腺瘤,16个结节为转移瘤,对全部结节的动脉期及门静脉期常规平扫CT值、虚拟平扫CT值、碘含量(ICad)结果进行分析。结果动脉期肾上腺腺瘤平均ICad[(24.65±1.06)mg/ml]略高于肾上腺转移瘤[(22.85±9.53)mg/ml],差异有统计学意义(P=0.002),门静脉期肾上腺腺瘤ICad[(13.96±1.11)mg/ml]低于肾上腺转移瘤[(24.70±5.49)mg/ml],差异有统计学意义(P=0.036)。腺瘤与转移瘤的动脉期、门静脉期虚拟平扫平均CT值(Va、Vp)与常规平扫CT值(Vpre)差异无统计学意义;腺瘤的Vpre、Va、Vp均低于转移瘤,差异具有统计学意义(P=0.006、0.008、0.006)。结论双能量CT技术能够通过虚拟平扫技术及碘含量测定技术对二者进行鉴别诊断,以减少受检者经济负担及减轻辐射剂量。

Objective To explore the clinical value of dual-source CT virtual plain scanning technique and iodine con- tent determination technique in differentiating benign with malignant adrenal lesions. Methods Forty patients with sus- pected adrenal lesion received plain CT scanning at authors＇ hospital, and a total of 40 adrenal nodules were detected, in- cluding 24 non-functioning adrenal adenomas and 16 metastatic lesions. The CT values of the nodules on plain CT scan and on arterial and portal venous phases as well as on virtual plain CT scan were determined, and the iodine contents （ICad） of the nodules were also calculated. The results were statistically analyzed. Results （ 1 ） In arterial phase, the mean ICad of adrenal adenoma was （24.65 ± 1.06） mg/ml, which was slightly higher than that of adrenal metastases [ （22.85 ±9.53 ） mg/ml ] , the difference was statistically significant （P = 0.002 ）. In portal venous phase, the mean ICad of adrenal adenoma was （13.96 ± 1. 11 ） mg/ml, which was lower than that of adrenal metastases [ （24.70 ± 5.49） mg/ml] , the difference was statistically significant （P = 0. 036）. （2） In arterial and portal venous phase, the mean CT values （Va and Vp） determined on virtual plain sean were not significantly different form the mean CT value （Vpre） determined on con- ventional plain CT scan. The Vpre, Va and Vp values of adrenal adenoma were lower than those of adrenal metastases, and the differenees were statistically significant （ P = 0. 006, P = 0. 008 and P = 0. 006 respectively）. Conclusion With the help of the virtual plain scanning technique and the estimation of iodine contents technique, dual-source CT scan can differ- entiate the adrenal adenomas from adrenal metastasis, which is helpful in reducing the medieal expense as well as the radia- tion dose.