AIM: To assess the value of gemstone spectral imaging (GSI) in efficacy evaluation in hepatocellular cancer (HCC) after transcatheter arterial chemoembolization (TACE) treatment.METHODS: Thirty patients with HCC under...AIM: To assess the value of gemstone spectral imaging (GSI) in efficacy evaluation in hepatocellular cancer (HCC) after transcatheter arterial chemoembolization (TACE) treatment.METHODS: Thirty patients with HCC underwent GSI, including nonenhanced, arterial, portalvenous and delayed phase scans, after TACE treatment. Arterial phase images were acquired with GSI for reconstruction of virtual nonenhanced images and color overlay images. Digital subtraction angiography (DSA) was performed in all these patients. Two blinded and independent readers evaluated the data in two reading sessions; standard nonenhanced, arterial, portalvenous, and delayed phase images were read in session A, and the optimal monochromatic images, iodine/water based images and spectrum features were read in session B. Sensitivity and specificity were calculated with the DSA data as the reference standard. The sensitivity and specificity were compared using the χ<sup>2</sup> test.RESULTS: DSA revealed 154 lesions in 30 patients, and 100 of them had blood supply. Overall sensitivity and specificity were 72% (72/100) and 77.8% (42/54) for session A, and 97% (97/100) and 94.4% (51/54) for session B, respectively. The sensitivity and specificity of the two reading sessions were significantly different (χ<sup>2</sup> = 23.04, χ<sup>2</sup> = 7.11, P < 0.05).CONCLUSION: Compared with conventional CT, GSI could significantly improve the detection of small and multiple lesions without increasing the radiation dose. Based on spectrum features, GSI could assess tumor homogeneity and more accurately identify residual tumors and recurrent or metastatic lesions during efficacy evaluation and follow-up in HCC after TACE treatment.展开更多
目的:探讨宝石能谱CT(GSI)低剂量对比剂肺动脉成像(CTPA)在肺动脉栓塞(PE)诊断中的价值。方法:选取2016年1月-2017年10月在本院临床拟诊PE需行CTPA检查的患者60例,按照随机数字表法将患者分为A组和B组,每组30例。两组均采用GE Discovery...目的:探讨宝石能谱CT(GSI)低剂量对比剂肺动脉成像(CTPA)在肺动脉栓塞(PE)诊断中的价值。方法:选取2016年1月-2017年10月在本院临床拟诊PE需行CTPA检查的患者60例,按照随机数字表法将患者分为A组和B组,每组30例。两组均采用GE Discovery CT 750 HD行CTPA检查,A组采用常规扫描模式,注射对比剂80 m L;B组采用GSI扫描模式,注射对比剂40 m L及0.9%氯化钠溶液40 m L。比较两组的图像质量客观评分、图像质量主观评分、肺动静脉CT差值、诊断阳性率,以及辐射剂量参数、最佳单能量情况。结果:经CTPA检查,A组阳性率为30.0%,与B组的26.7%比较,差异无统计学意义(P>0.05)。B组肺动脉的最佳单能量图像能量水平主要集中于60~70 keV。B组CTDI vol高于A组(P<0.05),A、B组间其他图像质量客观评价指标、图像质量主观评分及辐射剂量参数比较,差异均无统计学意义(P>0.05)。B组肺动脉与同水平静脉的CT差平均值均高于A组(P<0.05)。结论:基于GSI的低剂量对比剂CTPA检查可以获得满意的肺动脉图像,肺动脉各级分支显影良好,对于PE定位及范围判断符合临床诊断的要求,减少了对比剂的用量,具有较高的临床应用价值。展开更多
文摘AIM: To assess the value of gemstone spectral imaging (GSI) in efficacy evaluation in hepatocellular cancer (HCC) after transcatheter arterial chemoembolization (TACE) treatment.METHODS: Thirty patients with HCC underwent GSI, including nonenhanced, arterial, portalvenous and delayed phase scans, after TACE treatment. Arterial phase images were acquired with GSI for reconstruction of virtual nonenhanced images and color overlay images. Digital subtraction angiography (DSA) was performed in all these patients. Two blinded and independent readers evaluated the data in two reading sessions; standard nonenhanced, arterial, portalvenous, and delayed phase images were read in session A, and the optimal monochromatic images, iodine/water based images and spectrum features were read in session B. Sensitivity and specificity were calculated with the DSA data as the reference standard. The sensitivity and specificity were compared using the χ<sup>2</sup> test.RESULTS: DSA revealed 154 lesions in 30 patients, and 100 of them had blood supply. Overall sensitivity and specificity were 72% (72/100) and 77.8% (42/54) for session A, and 97% (97/100) and 94.4% (51/54) for session B, respectively. The sensitivity and specificity of the two reading sessions were significantly different (χ<sup>2</sup> = 23.04, χ<sup>2</sup> = 7.11, P < 0.05).CONCLUSION: Compared with conventional CT, GSI could significantly improve the detection of small and multiple lesions without increasing the radiation dose. Based on spectrum features, GSI could assess tumor homogeneity and more accurately identify residual tumors and recurrent or metastatic lesions during efficacy evaluation and follow-up in HCC after TACE treatment.
文摘目的:探讨宝石能谱CT(GSI)低剂量对比剂肺动脉成像(CTPA)在肺动脉栓塞(PE)诊断中的价值。方法:选取2016年1月-2017年10月在本院临床拟诊PE需行CTPA检查的患者60例,按照随机数字表法将患者分为A组和B组,每组30例。两组均采用GE Discovery CT 750 HD行CTPA检查,A组采用常规扫描模式,注射对比剂80 m L;B组采用GSI扫描模式,注射对比剂40 m L及0.9%氯化钠溶液40 m L。比较两组的图像质量客观评分、图像质量主观评分、肺动静脉CT差值、诊断阳性率,以及辐射剂量参数、最佳单能量情况。结果:经CTPA检查,A组阳性率为30.0%,与B组的26.7%比较,差异无统计学意义(P>0.05)。B组肺动脉的最佳单能量图像能量水平主要集中于60~70 keV。B组CTDI vol高于A组(P<0.05),A、B组间其他图像质量客观评价指标、图像质量主观评分及辐射剂量参数比较,差异均无统计学意义(P>0.05)。B组肺动脉与同水平静脉的CT差平均值均高于A组(P<0.05)。结论:基于GSI的低剂量对比剂CTPA检查可以获得满意的肺动脉图像,肺动脉各级分支显影良好,对于PE定位及范围判断符合临床诊断的要求,减少了对比剂的用量,具有较高的临床应用价值。
文摘目的探讨能谱CT在鉴别肝脏单纯囊肿（HC）和肝脏单房囊性包虫（UHCE）的应用价值。方法回顾性分析39例肝脏单房囊性占位病变患者,其中HC 19例（HC组）,UHCE 20例（UHCE组）,行平扫和三期增强能谱CT扫描后获得40~140keV单能图像病灶的CT值、碘（水）浓度、水（碘）浓度、有效原子序数,测量正常肝组织和腹主动脉碘值,计算不同期相标准化碘浓度（NIC）和病灶与周围正常肝组织碘浓度比值（LNR）,对两组结果进行统计学分析,并进行ROC曲线分析。结果 HC 40~50keV平扫、动脉期及延迟期单能量CT值均低于UHCE（P均〈0.05）,平扫和增强三期HC的碘（水）浓度低于UHCE（P〈0.05）,平扫、动脉期及延迟期HC的有效原子序数低于UHCE（P〈0.05）;平扫和动脉期HC的NIC高于UHCE（P均〈0.05）;HC动脉期水（碘）浓度略低于UHCE（P〈0.05）;平扫40keV下鉴别HC和UHCE的敏感度（100%）和特异度最高（75%）。结论能谱CT成像的定量分析对HC和UHCE的鉴别诊断有一定价值。
