双能量CT碘图相关定量参数联合CT征象建模鉴别肺癌病理亚型的应用价值

目的探讨双能量CT(DECT)碘图相关定量参数联合CT征象建模鉴别肺癌病理亚型的应用价值。方法2017年1月至2019年1月连续纳入疑似肺癌患者162例,其中110例患者明确肺癌病理组织分型。评估110例肺癌患者的CT形态学特征,并测量病变碘图相关定量参数(碘浓度、碘比值)。比较不同肺癌亚型之间CT征象及碘图相关定量参数的差异。结果110例肺癌患者中,腺癌48例,鳞癌36例,小细胞肺癌26例。3种肺癌亚型的大部分CT征象差异有统计学意义(P<0.05)。腺癌及鳞癌患者碘浓度及碘比值均高于小细胞肺癌,差异有统计学意义(P<0.05)。CT征象模型诊断准确率为69.1%,CT征象联合碘图相关定量参数诊断准确率为80.9%。结论DECT碘图定量联合CT征象可提高诊断肺癌亚型的准确率。

MRI相关定量参数在肩峰下撞击综合征诊断中的价值及与肩关节功能、治疗效果的关系

为分析MRI相关定量参数对肩峰下撞击综合征(SIS)的诊断价值,本研究将56例SIS患者设为SIS组,同期56例健康体检者设为对照组,对比了两组对象的一般资料、肩关节功能评分(Constant评分)及MRI相关定量参数水平,探讨了MRI定量参数与Constant评分、SIS发病相关影响因素、治疗效果的关系及对SIS的诊断价值。结果显示SIS组Constant评分、最短肩肱间距低于对照组,肩峰指数、肩锁关节骨赘高度高于对照组,且SIS组治疗有效患者肩峰指数、肩锁关节骨赘高度低于无效患者,最短肩肱间距高于无效患者(P<0.05);SIS患者肩峰指数、肩锁关节骨赘高度与Constant评分呈负相关,而最短肩肱间距与其呈正相关(P<0.05);各MRI相关定量参数均为SIS发病的重要影响因素(P<0.05)。应用各MRI相关定量参数联合诊断SIS特异度为87.50%,敏感度为80.36%。由此可知MRI相关定量参数对SIS诊断价值较高,且与肩关节功能和治疗效果有关。

磁共振相关定量参数与肩峰下撞击综合征(SIS)的相关性分析

目的分析磁共振检查设备相关的定量测量参数与肩峰下撞击综合征之间的相关性。方法选取80例患者为观察组,并80例健康者为对照组,均采用MRI设备进行检查,对比肩关节功能评分。观察和比较二组的肩峰形态、MRI各项参数。结果观察组肱骨头囊变直径、最短肩肱间距、Constant评分均低于对照组(P<0.05),肩峰角、肩峰指数、喙肩韧带、肩峰下积液厚度、肩锁关节骨赘高度均高于对照组(P<0.05);两组人员中,观察组Ⅰ型、Ⅱ型和Ⅲ型肩峰占比均高于对照组,结果比较,P>0.05。此外,依据Pearson相关系数分析法,得出肩锁关节骨赘高度与Constant评分是呈现负性关系(即P<0.05),同时,最短肩肱间距则是呈现正性关系(即P<0.05),反之,其他参数并未有相关性(P>0.05)。结论通过MRI检查SIS患者的最短肩肱间距、肩锁关节骨赘高度能够判断肩关节活动功能损害程度,具有一定的相关性。

Correlation of the quantifiable parameters of blood flow pattern derived with dynamic CT in solitary bronchogenic adenocarcinoma

Objective:To evaluate the correlation of the quantifiable parameters of blood flow pattern derived with dynamic CT in solitary bronchogenic adenocarcinoma(SBA).Methods:46 patients with solitary bronchogenic adenocarcinomas (SBA)(diameter≤4 cm)underwent multi-location dynamic contrast material-enhanced(nonionic contrast material was administrated via the antecubital vein at a rate of 4 mL/s by using an autoinjector 90 mL,4×5 mm or 4×2.5 mm scanning mode with stable table were performed)serial CT.Precontrast and postcontrast attenuation on every scan was recorded.Perfusion (PBA),peak height(PHBA),ratio of peak height of the SPN to that of the aorta(BA-to-A ratio)and mean transit time(MTT)were calculated.The correlation between peak height of the aorta(PHA)and parameters of the SBA(PHBA,BA-to-A ratio,PBA,and MTT)and those among parameters of the SBA were assessed by means of linear regression analysis.Regression equation among parameters of the SBA were obtain by means of stepwise regression.Results:The correlation between the SBA peak height(PHBA,36.78 HU±12.02)and the aortic peak height(PHA)was significant(r=0.506,P<0.0001).No significant cor- relation was found between the BA-to-Apeak height ratio(15.33%±4.55)and the aortic peak height(r=0.130,P=0.388> 0.05)as it was between the SBA perfusion(PBA,31.86 mL/min/100 g±9.74)and the aortic peak height(r=0.049,P=0.749 >0.05).The SBA perfusion correlated with the PHBA and the BA-to-A peak height ratio(r=0.394,P=0.007<0.05;r=0.407, P=0.005<0.05).The PHBA correlated positively with the BA-to-A peak height ratio(r=0.781,P<0.0001).Mean transit time was 14.84 s±5.52.PBA=18.500+0.872×BA-to-A ratio.BA-to-A ratio=4.467+0.295×PHBA.Conclusion:The linear correlation between the SBA perfusion and BA-to-Aratio and that between BA-to-Aratio and PHBA can be expressed by equation. It is possible to design a simpler scanning procedure of investigation of bronchogenic adenocarcinoma angiogenesis.