能谱CT在乳腺癌诊断中的初步应用

Preliminary Application of Spectral CT in the Diagnosis of Breast Cancer

目的探讨能谱CT在乳腺癌评估中的应用价值,为临床提供影像学辅助信息。资料与方法回顾性分析2016年5月-2017年2月兰州总医院经手术病理证实并行术前能谱CT双期增强扫描的乳腺癌患者12例,其中6例伴有淋巴结转移。以对侧正常腺体为对照,测量双期乳腺癌病灶及对侧正常腺体40~140 ke V下的平均CT值、能谱曲线斜率、碘(水)浓度及相对碘浓度。绘制原发灶及转移性淋巴结的能谱曲线、直方图及散点图。以12例胸部常规CT双期增强扫描的女性患者为对照进行辐射剂量对比评估,评估参数包括CT容积剂量指数、剂量长度乘积、有效辐射剂量。结果乳腺癌动、静脉期的各项能谱参数均明显高于正常腺体,差异有统计学意义(P<0.05)。能谱CT胸部双期增强扫描的平均有效辐射剂量明显低于常规CT,差异有统计学意义(P<0.05)。6例伴淋巴结转移的乳腺癌,原发灶与转移性淋巴结的能谱曲线、直方图及散点图均表现为在静脉期一致性较高。结论乳腺癌能谱参数的特征性表现有利于病变的进一步诊断。原发灶与转移淋巴结在能谱曲线、直方图及散点图等方面的一致性有助于淋巴结的定性诊断。能谱CT胸部双期增强扫描具有较低的辐射剂量,弥补了传统CT因辐射剂量问题在乳腺病变定性诊断方面的应用局限。因此,能谱CT在诊断乳腺癌方面具有一定的应用价值。

Purpose To explore the preliminary application of spectral CT in the diagnosis of breast cancer, in order to provide more imaging supplemental information for clinical studies. Materials and Methods Twelve patients with pathologically confirmed breast cancer underwent preoperative spectral CT dual-phase contrastenhanced scans in General Hospital of Lanzhou from May 2016 to February 2017 were retrospectively analyzed, including 6 patients with lymph node metastasis. With contralateral normal breast as the control group, the CT values at 40-140 ke V, spectral curve slopes, iodine contents and relative iodine contents of breast cancer were measured in dual phase. The spectral curve, histogram, scatter plot of primary lesions and metastatic lymph nodes were drawn. In order to compare the radiation doses, 12 female patients undergoing dual-phase contrast-enhanced scans with traditional CT were included randomly as the control group, and the radiation dose evaluation parameters included volume CT dose index, dose-length product, effective dose. Results All the spectral parameters of breast cancer in arterial phase and venous phase were higher than those of normal breast, and the differences were statistically significant（P〈0.05）. The average effective dose of spectral CT dual-phase contrastenhanced scans was lower than that of regular CT, and the difference was statistically significant（P〉0.05）. For the 6 patients with lymph node metastasis, the spectral curve, histogram and scatter plot of primary lesions and metastatic lymph nodes were in higher consistency in venous phase. Conclusion The special spectral parameters of breast cancer contribute to the further diagnosis of lesions. The consistence of spectral curve, histogram and scatter plot of primary lesions and metastatic lymph nodes is helpful for the identification of lymph nodes. Spectral CT breast dual-phase contrastenhanced scans use lower radiation dose, which makes up for the deficiency of traditional CT in the qualitative diagnosis of breast diseases due to higher radiation dose. Therefore, spectral CT is of certain clinical application value in the diagnosis of breast cancer.