双源CT双能量虚拟平扫在原发性肝癌的应用

Application of Dual-Source CT and Virtual Non-Contrasted in Primary Liver Cancer

目的分析双源CT(DSCT)双能量虚拟平扫(VNC)在原发性肝癌中的应用价值。方法选取2016年9月至2018年9月我院收治的肝占位性病变患者106例为研究对象,均进行CT平扫及双能量增强扫描,记录其扫描时间、病灶检出率、定性诊断率、临床分期率、CT值、信噪比(SNR)、图像质量评分、辐射剂量[容积CT剂量指数、剂量长度乘积(DLP)、有效剂量(ED)],对比原发性肝癌、肝脏良性病变的VNC特点,分析VNC对原发性肝癌的诊断价值。结果双能量增强扫描下获得的VNC扫描时间短于CT平扫,容积CT剂量指数、DLP、ED低于CT平扫,而VNC的病灶检出率、定性诊断率、临床分期率、CT值、SNR值、图像质量评分高于CT平扫。106例患者中DSCT检出原发性肝癌41例,肝脏良性病变65例(其中肝血管瘤33例,局灶性结节性增生17例,脂肪肝15例),与肝脏良性病变相比,原发性肝癌者BF、BV升高,TTS延长,PS增加(P<0.05)。结论DSCT下双能量增强扫描获得的VNC图像对原发性肝癌有较高诊断价值,其CT值及SNR较高,病灶检出率高,图像质量也能满足临床诊断需求,值得在临床推广应用。

Objective To analyze the application value of dual-source computed tomography(DSCT)and virtual non-contrast(VNC)imaging in primary liver cancer.Methods A total of 106 patients with hepatic space-occupying lesions admitted to the hospital from September 2016 to September 2018 were enrolled in the study.All patients underwent a CT plain scan and dual-energy enhanced scan.The scan time,lesion detection rate,qualitative diagnosis rate,clinical-stage rate,CT value,signal-noise ratio(SNR),image quality score,and radiation dose[CT dose index volume(CTDIVOL),dose length product(DLP),effective dose(ED)]were recorded.The VNC features of primary liver cancer and benign liver lesions were compared.The diagnostic value of VNC for primary liver cancer was analyzed.Results The VNC scan time of the dual-energy enhanced scan was shorter than that of CT plain scan,and CTDIVOL,DLP,and ED were lower than those of CT plain scan.The lesion detection rate,qualitative diagnosis rate,clinical-stage rate,CT value,SNR value,and image quality score of VNC were higher than those of CT plain scan.Of the 106 patients,there were 41 cases with primary liver cancer and 65 cases with benign liver lesions(including 33 cases with hepatic hemangioma,17 cases with focal nodular hyperplasia,15 cases with fatty liver)detected by DSCT.Compared with benign liver lesions,bF and bV were increased in patients with primary liver cancer,TTS was prolonged,and PS was increased(P<0.05).Conclusion VNC images under DSCT obtained by the dual-energy enhanced scan are of relatively higher diagnostic value for primary liver cancer.The CT value and SNR are relatively higher;the lesion detection rate is high.Therefore,image quality can meet clinical diagnosis demands.