宝石能谱CT物质定量分析对肝硬化结节与癌性结节鉴别诊断的临床价值

目的：探讨宝石能谱CT物质定量分析对肝硬化再生结节与癌性结节鉴别的临床价值。方法：搜集2014年2-6月在本院行能谱CT三期增强扫描并经病理证实的肝占位患者33例,其中肝硬化再生结节22例,癌性结节11例,对比两组病例的能谱图像,算出不同能量时病灶与肝实质对比噪声比（CNR）、标准化碘浓度（NIC）、病灶与正常肝实质含碘浓度比值（LNR）、病灶动脉期和门脉期碘浓度差异（ICD）。结果：肝硬化再生结节与癌性结节在不同能量下病灶-肝脏对比噪声比有一定规律,随着能量的增加,病灶-肝脏对比噪声比减少（P〈0.05）。癌性结节动脉期和门静脉期的标准化碘浓度、碘浓度比值和碘浓度的差异值均低于肝硬化再生结节。动脉期病灶与正常肝实质含碘浓度比值鉴别肝硬化再生结节与癌性结节的敏感性和特异性均为100%。结论：能谱CT物质定量分析对肝硬化再生结节与癌性结节的鉴别诊断有巨大临床价值,能提高诊断准确性。

Clinical Value of Gemstone Spectral CT Quantitative Analysis in the Differential Diagnosis of Hepatic Cirrhosis Nodules and Cancerous Nodules

Objective：To discussion clinical value of of gemstone spectral CT quantitative analysis in liver cirrhosis with regenerating the differential diagnosis and cancer nodules.Method： 33 patients by the energy spectrum of CT three phases enhanced scan and pathologically proved hepatic in our hospital from February 2014 to June 2014, there were cirrhosis regenerated nodular in 22 cases, 11 cases of cancerous nodules, energy spectrum image were compared between two groups, calculated the different energy lesions and liver parenchyma contrast to noise ratio（CNR）, the standardization of iodine concentration（NIC）, the lesions and normal liver parenchyma iodine concentration ratio（LNR）, different concentration of iodine lesions in arterial phase and portal venous phase（ICD）, two samples t test on the two groups of data.Result：Cirrhosis regenerated nodular carcinoma and nodular lesions in the liver at different energyin contrast to noise ratio have certain rules, with the increase of the energy, focal liver contrast to noise ratio decrease（P〈0.05）. Differences between cancer nodular arterial phase and portal venous phase standard concentration of iodine, iodine concentration ratio and iodine concentration values were lower in cirrhosis regenerated nodular. Arterial lesions and normal liver parenchyma iodine concentration ratio in differentiating cirrhosis regenerated nodular and cancerous nodules sensitivity and specificity were 100%.Conclusion：The energy spectrum of CT quantitative analysis in the differential diagnosis of cirrhosis regenerated nodular and cancerous nodules have great clinical value, can improve the accuracy of diagnosis.