宝石能谱CT在鉴别肝脏血管瘤与转移瘤中的应用价值

The application value of gemstone spectral CT in the differential diagnosis of liver hemangioma and metastases

目的分析宝石能谱CT在肝脏血管瘤与转移瘤鉴别诊断中的价值。方法回顾性分析15例肝脏血管瘤及15例肝脏转移瘤患者能谱成像在不同单能量下CT值的特点、各组基物质浓度及能谱曲线斜率的差异。结果宝石能谱CT平扫肝脏血管瘤组与肝脏转移瘤组在40~140 keV的11个不同keV单能量下的CT值差异无统计学意义(P>0.05),能谱曲线走行均呈上升型。动脉期肝脏血管瘤组与肝脏转移瘤组在40~110 keV的8个不同keV单能量下的CT值比较,差异有统计学意(P<0.05或P<0.01);肝脏血管瘤组呈上升型,肝脏转移瘤组呈下降型。门静脉期肝脏血管瘤组与肝脏转移瘤组在40~140 keV的11个不同keV单能量下的CT值差异有统计学意义(P<0.05或P<0.01),能谱曲线均呈下降型。延迟期肝脏血管瘤组与肝脏转移瘤组在40~120 keV的9个不同keV单能量下的CT值,差异有统计学意义(P<0.05或P<0.01),能谱曲线均呈下降型。肝脏血管瘤组中的各组基物质(水—碘、碘—水、水—钙、钙—水、碘—钙、钙—碘)含量均高于肝脏转移瘤组,差异有统计学意义(P<0.01)。结论宝石能谱CT单能量图像、各组基物质、能谱曲线及斜率的测定,对肝脏血管瘤与肝脏转移瘤的鉴别诊断有一定的价值。

Objective To explore the application of gemstone spectral CT in the differential diagnosis of liver hemangioma and metastases. Methods The characteristics of CT values at different single energies and the differences in the slopes of the energy spectrum curves and the base material concentrations in 15 patients with liver hemangiomas and 15 patients with liver metastases were retrospectively analyzed. Results There was no statistically significant difference in the CT values between the liver hemangioma group and liver metastatic tumor group at 11 different keV single energies between 40-140 keV(P〈0. 05）. The spectrum curve runs upwards. The difference in CT values between arterial liver hemangiomas and liver metastases at 8 different single keV energies between 40 and 110 keV was statistically significant(P〈0. 05 or P〈0. 01）. liver hemangiomas showed an ascending type,while the liver metastases group showed a decline type. The CT values of portal liver hemangioma group and liver metastasis group at 11 different single keV energies between 40-140 keV were statistically significant(P〈0. 05 or P〈0. 01）,and the energy spectrum curves were both in declined type. The CT values of liver hemangiomas and liver metastases in the delayed stage at 9 different single keV energies between 40 and 120 keV were statistically significant(P〈0. 05 or P〈0. 01）. Both showed a decline. Each paired base material in the liver hemangiomas group(iodinewater,water-iodine,water-calcium,calcium-water,iodine-calcium,calcium-iodine） were higher than the metastases group,each difference has statistical significance(P〈0. 01）. Conclusion The gem energy spectrum CT single energy image,the determination of each group of base materials,energy spectrum curve and slope,has a certain contribution for the differential diagnosis of liver hemangiomas and liver metastases.