ISSN 1004-4140
CN 11-3017/P
张静, 李宏磊, 张婷, 卜玉莲, 陈晓炎, 房炜桓, 徐敬慈, 潘自来, 陈克敏, 李卫侠, 邵丹丹, 林晓珠, 严福华. 能谱CT多参数成像在胰岛素瘤定位中的比较研究[J]. CT理论与应用研究, 2019, 28(4): 471-476. DOI: 10.15953/j.1004-4140.2019.28.04.08
引用本文: 张静, 李宏磊, 张婷, 卜玉莲, 陈晓炎, 房炜桓, 徐敬慈, 潘自来, 陈克敏, 李卫侠, 邵丹丹, 林晓珠, 严福华. 能谱CT多参数成像在胰岛素瘤定位中的比较研究[J]. CT理论与应用研究, 2019, 28(4): 471-476. DOI: 10.15953/j.1004-4140.2019.28.04.08
shu
ZHANG Jing, LI Honglei, ZHANG Ting, BU Yulian, CHEN Xiaoyan, FANG Weihuan, XU Jingci, PAN Zilai, CHEN Kemin, LI Weixia, SHAO Dandan, LIN Xiaozhu, YAN Fuhua. Comparison in Localization of Pancreatic Insulinoma by the Multiparameter of Dual Energy Spectral CT Imaging[J]. CT Theory and Applications, 2019, 28(4): 471-476. DOI: 10.15953/j.1004-4140.2019.28.04.08
Citation: ZHANG Jing, LI Honglei, ZHANG Ting, BU Yulian, CHEN Xiaoyan, FANG Weihuan, XU Jingci, PAN Zilai, CHEN Kemin, LI Weixia, SHAO Dandan, LIN Xiaozhu, YAN Fuhua. Comparison in Localization of Pancreatic Insulinoma by the Multiparameter of Dual Energy Spectral CT Imaging[J]. CT Theory and Applications, 2019, 28(4): 471-476. DOI: 10.15953/j.1004-4140.2019.28.04.08
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能谱CT多参数成像在胰岛素瘤定位中的比较研究

Comparison in Localization of Pancreatic Insulinoma by the Multiparameter of Dual Energy Spectral CT Imaging

    摘要
  • 摘要: 目的：比较能谱CT多参数联合诊断与常规CT图像、最佳keV能量图、70 ke V单能量图像、碘基图在胰岛素瘤定位诊断中的应用价值。方法：回顾性分析病理证实的42例胰岛素瘤患者资料，通过能谱分析软件，选择70 ke V单能量值、最佳ke V能量图像和碘基图进行重建，观察能谱CT多参数联合诊断与常规CT图像、最佳keV能量图、70 keV单能量图像、碘基图的检出率。分析病例能谱CT进行腹部双期增强扫描。结果：动脉期和静脉期常规CT图像、70 keV能量、最佳keV能量图像、碘基图、能谱多参数图像的检出率分别为，69%（29）、71.4%（30/42）、90.5%（38/42）、90.5%（38/42）、92.9%（39/42）和47.6%（20）、47.6%（20）、64.3%（27）、69%（29）、76.2%（32）（表1）。动脉期能谱多参数图像检出率（92.9%）大于最佳keV图像检出率（90.5%）等于碘基图病灶检出率（90.5%）大于70 ke V图像（71.4%）大于常规CT图像（69.0%），卡方检验Fisher精确概率法结果χ2=14.191，P=0.004，认为动脉期五组检出率具有统计学差异，其中以能谱多参数图像检出效能最高，常规CT图像最低；静脉期常规CT图像、70 keV能量、最佳keV能量图像、碘基图、能谱多参数图像的检出率比较，Pearson卡方结果χ2=11.724，P=0.02，认为静脉期五组检出率具有统计学差异。虽然动脉期检出率高于门静脉期，但部分胰岛素瘤仅在静脉期显影，因此能谱CT需要对动脉期和静脉期结合观察才能减少漏诊。

     

    Abstract: Objective: To compare the multiparameter of dual energy spectral CT imaging in localization of pancreatic Insulinoma.Materials and Methods: 42 patients were included in this study with underwent the dual-phase DEsCT imaging.Their CT images were interpreted retrospectively by two radiologists.All the patients had been confirmed pathologically.Results: 70 ke V mono-energy imaging detected 30, 20 of 42 tumors, in arterial phase and venous phase, separately;the optimal CNR monochromatic imaging detected 38, 27 of 42 tumors, in arterial phase and venous phase, separately;the iodine density imaging detected 38, 29 of 42 tumors and 39, 32 of42 tumors detected with the combination of the three kinds of images, in arterial phase and venous phase, separately.71.4%(30/42), 90.5%(38/42), 90.5%(38/42), 92.9%(39/42) and 47.6%(20), 64.3%(27), 69%(29), 76.2%(32).Conclusion: The optimal CNR monochromatic imaging has highest sensitivity in localization of insulinomas compared with the 70 ke V mono-energy imaging and the iodine density imaging.The combination of monochromatic image and iodine density image can improve the sensitivity of locating insulinomas.

     

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