双能量CT在肾癌诊断及分型中的应用

目的 探讨双能量CT虚拟平扫及双能量碘分布图在肾癌诊断及分型中的应用价值.方法 收集35例肾癌患者双能量增强CT扫描数据及病理结果,分析双能量CT虚拟平扫的图像质量及辐射剂量、双能量碘分布图在透明细胞癌及非透明细胞癌中存在的差异.结果 虚拟平扫与常规平扫图像质量相当,CT值[常规平扫：肾实质（31.90±4.10） HU,腹主动脉（45.60±6.30） HU,腰大肌（50.00±6.63） HU,肾癌（1.41±17.06） HU;虚拟平扫：肾实质（33.20±5.50） HU,腹主动脉（48.30±8.00）HU,腰大肌（52.40±10.63） HU,肾癌（0.87±17.48） HU]、信噪比（常规平扫：肾实质3.22±1.49,腹主动脉5.13±2.57,腰大肌4.56±2.12,肾癌3.24±2.27;虚拟平扫：肾实质2.73±1.08,腹主动脉3.79±1.64,腰大肌3.23±1.35,肾癌2.18±1.57）差异均无统计学意义（均P＞0.05）.透明细胞癌在皮髓交界期碘分布图像碘值[（2.75±1.05） mg/ml]高于非透明细胞癌[（1.25±0.72） mg/ml],差异有统计学意义（t=7.048,P＜0.05）.结论 肾癌患者CT检查中虚拟平扫图像质量近似于常规平扫,降低了辐射剂量.碘分布图可以提供更多的诊断信息,可以更直观准确地判断肾癌的血供和亚型.

Application of dual-source dual-energy CT scanning in diagnosis and typing of renal cell carcinoma

Objective To investigate the value of dual-energy virtual unenhanced and dual-energy iodine value distribution diagram type of kidney cancer.Methods A retrospective analysis of 35 cases of renal cell carcinoma dual-energy CT scan data,compared to kidney pathology data,analyze the image quality and radiation dose dual-energy virtual unenhanced and dual energy distribution of iodine in clear cell carcinoma and non-clear cell carcinoma the differences that exist.Results Unenhanced and virtual unenhanced image quality was quite,CT value （routine unenhanced renal parenchyma 31.90±4.10 HU,abdominal aortic 45.60±6.30 HU,psoas 50.00±6.6 HU3,kidney 1.410±17.06 HU; virtual unenhanced renal parenchyma abdominal aortic 33.20±5.50 HU,48.30±8.00 HU,52.40±10.63 HU psoas kidney 0.87±17.48 HU）,signal to noise ratio （routine unenhanced renal abdominal aorta 3.22±1.49,5.13±2.57,4.56±2.12 psoas kidney 3.24±2.27 virtual unenhanced renal abdominal aorta 2.73±1.08,3.79±1.64,3.23±1.35 psoas kidney 2.18± 1.57） had not significantly different （P 〉 0.05）.Clear cell carcinoma of the skin medullart junction of iodinedistribution of images Iodine （2.75±1.05） mg/ml was higher than non-clear cell carcinoma （1.25±0.72） mg/ml,the difference was statistically significant （t =7.048,P 〈 0.05）.Conclusions CT examination in patients with renal cell carcinoma virtual unenhanced image quality is similar with routine unenhanced image quality,it reduces radiation dose.The distribution of iodine can provide more diagnostic information that can help us be more intuitive and accurate judgments of the blood supply and kidney cancer subtypes.