双能CTA在肾癌术前评估中的新应用

New applications of Dual-energy CTA in the preoperative evaluation of kidney cancer

目的通过双能CTA与常规CTA在肾癌术前评估中的对比研究,探讨双能CTA在肾癌术前评估中的新应用。方法从肾癌患者中随机挑选行双能CTA检查的30例,行常规CTA检查的30例,分别重建VR、MIP、CPR图像;对行双能CTA的患者行虚拟平扫及碘分布图重建;对比两种方法在肾癌供血动脉、变异血管的图像质量、图像重建效率、辐射剂量、定性诊断价值方面各自的优势。结果双能CTA组图像质量评分为:1分7例(23.4%)、2分12例(40.0%)、3分10例(33.3%)、4分1例(3.3%);常规CTA组图像质量评分为:1分8例(26.7%)、2分13例(43.3%)、3分9例(30.0%)、4分0例(0),P值均大于0.05,故两组显示血管图像质量无明显差异。双能CTA图像处理时间为(303±18)秒,常规CTA图像处理时间为(581±36)s,两组图像重建时间对比差异具有统计学意义(P<0.05)。双能CTA组因为有虚拟平扫功能,从而较常规CTA组减少一次平扫,故辐射剂量低于常规CTA组,并且双能CTA能定量分析肾癌瘤体的强化程度。结论双能CTA与常规CTA相比,不仅优化了常规CTA的图像后处理功能,还增加了虚拟平扫及碘分布图重建功能,使肾癌的术前评估更加准确、快捷、安全、全面。

Objective By the comparative research of dual-energy CTA and conventional CTA in the preoperative evaluation of kidney cancer, to explore the new applications of dual-energy CTA in preoperative evaluation of kidney cancer. Methods 30 cases of patients using dual-energy CTA and 30 cases of patients using routine CTA examination were randomly selected from the kidney cancer patients. They were given reconstruction of VR, MIP, CPR images. Patients with dual-energy CTA were given virtual scan and iodine distribution reconstruction. Kidney artery blood supply, the variation of the blood vessels image quality, image reconstruction efficiency, radiation dose, the qualitative diagnosis value their advantages of the two groups were compared. Results Image quality score of dualenergy CTA group were 1 point 7 cases （23.4%）, 2 points 13 cases （40.0%）, 3 points 10 cases （33.3%）, and 4 points 0 cases （3.3%）. Image quality score of routine CTA group were 1 point 8 cases （26.7%）, 2 points 13 cases （43.3%）, 3 points 9 cases （30.0%）, and 4 points 0 cases （0）. P values were greater than 0.05, the two groups showed no difference on the blood vessel image quality. Dual-energy CTA image processing time was （303 ±18）s, conventional CTA image processing time was （581 ±36）s, the two sets of image reconstruction time contrast differences statistically significant （P 〈 0.05）. For dual-energy CTA group, because there were virtual scan function, there reduced a scan in the routine CTA group, so the radiation dose was lower than the routine CTA group, and dual-energy CTA could quantitative analysis of the degree of strengthening kidney tumors. Conclusion Compared with conventional CTA, dual-energy CTA can optimize the routine CTA image post-processing function, add virtual scan and iodine distribution reconstruction function, and it can make kidney preoperative assessment more accurate and fast, safe and comprehensive.