本文關(guān)鍵詞： 體層攝影術(shù) X線計(jì)算機(jī) 能譜成像 腎上腺 腺瘤 轉(zhuǎn)移瘤 診斷　出處：《中國全科醫(yī)學(xué)》2015年11期 　論文類型：期刊論文

【摘要】：目的探討雙源CT對腎上腺少脂肪型腺瘤和轉(zhuǎn)移瘤的鑒別診斷價(jià)值。方法 2011年5月—2012年12月于河北醫(yī)科大學(xué)第四醫(yī)院就診的50例腎上腺結(jié)節(jié)患者均使用雙源CT對病灶進(jìn)行平掃。測定融合圖像中病灶的CT值;選擇"mono energy"軟件測量后得到能譜曲線,并計(jì)算其斜率。同時(shí)與病理結(jié)果進(jìn)行比較。結(jié)果經(jīng)手術(shù)或病理確診腎上腺少脂肪型腺瘤22例,腎上腺轉(zhuǎn)移瘤28例。經(jīng)雙源CT檢查,50例患者中腎上腺少脂肪型腺瘤14例(腎上腺少脂肪型腺瘤組),腎上腺轉(zhuǎn)移瘤36例(轉(zhuǎn)移瘤組)。腎上腺少脂肪型腺瘤組與轉(zhuǎn)移瘤組的融合圖像平均CT值分別為(30.6±15.8)HU和(37.3±16.5)HU,差異無統(tǒng)計(jì)學(xué)意義(t=1.14,P0.05);兩組能譜曲線平均斜率分別為(-0.23±0.12)、(0.37±0.33),差異有統(tǒng)計(jì)學(xué)意義(t=2.36,P0.05)。以能譜曲線斜率0.04為診斷閾值鑒別腎上腺少脂肪型腺瘤與轉(zhuǎn)移瘤時(shí),曲線下面積為0.901、靈敏度為91.8%、特異度為81.8%。結(jié)論雙源CT診斷腎上腺少脂肪型腺瘤和轉(zhuǎn)移瘤的結(jié)果,與手術(shù)或病理確診結(jié)果的符合程度較高,且經(jīng)雙源CT檢查時(shí),腎上腺少脂肪型腺瘤的能譜曲線斜率高于轉(zhuǎn)移瘤,因此雙源CT能譜成像可能成為鑒別腎上腺少脂肪型腺瘤與轉(zhuǎn)移瘤的有用工具。
[Abstract]:Objective to investigate the value of dual source CT in the differential diagnosis of adrenal oligoadipose adenoma and metastatic tumor. Methods from May 2011 to December 2012, 50 patients with adrenal nodules in Hebei Medical University 4th Hospital were treated with double source CT scan. The CT values of the lesions in the fusion images were measured. The energy spectrum curve was obtained by using "mono energy" software, and the slope was calculated. Results 22 cases of adrenal oligoaliphatic adenoma were confirmed by operation or pathology, and the results were compared with those of pathology. There were 28 cases of adrenal metastases. Among them, 14 cases were adrenal oligoadipose adenoma (adrenal oligoadipose adenoma), 36 cases were adrenal metastasis (metastasis group). The mean CT values of fusion images in the tumor group were 30.6 鹵15.8HU and 37.3 鹵16.5HUU, respectively. There was no significant difference between the two groups, and the mean slope of the energy spectrum curve was -0.23 鹵0.12, 0.37 鹵0.33, respectively. The difference was statistically significant. The slope of the energy spectrum curve was 0.04 as the diagnostic threshold for the differential diagnosis of adrenal adipose. Type A adenoma and metastatic tumor, The area under the curve is 0.901, the sensitivity is 91.8 and the specificity is 81.8. Conclusion the results of dual-source CT in diagnosis of adrenal oligoadipose adenoma and metastatic tumor are in good agreement with the results of surgical or pathological diagnosis. The slope of energy spectrum curve of adrenal oligoadipose adenoma is higher than that of metastatic tumor, so dual-source CT energy dispersive imaging may be a useful tool for differentiating adrenal oligoadipose adenoma from metastatic tumor.
【作者單位】： 河北醫(yī)科大學(xué)第四醫(yī)院CT、MR室;
【基金】：河北省衛(wèi)生廳醫(yī)學(xué)科學(xué)研究重點(diǎn)課題計(jì)劃項(xiàng)目(200905011)
【分類號】：R736.6;R730.44

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