ISSN 1004-4140
CN 11-3017/P

CT肺减影成像在评价胸部占位性病变强化程度中的应用价值

The Value of Subtraction Computed Tomography in Evaluating the Enhancement Degree of Thoracic Lesions

  • 摘要: 目的:探讨CT肺减影成像在评价胸部占位性病变强化程度中的应用价值。方法:回顾性收集因胸部占位行胸部增强CT检查的患者,所有患者均采用CT肺减影成像序列扫描。经减影后处理得到动、静脉期的病灶碘分布彩色融合图。测量并计算动、静脉期无减影CT的强化净增值(∆Hu,∆Hu=强化后CT值-平扫CT值);病灶强化程度分为轻度强化(∆Hu<20 HU)、中度强化(∆Hu为20~40 HU)和显著强化(∆Hu>40 HU)。对CT肺减影伪彩图进行视觉评估,依据彩图的色阶将病灶碘分布程度分为轻度、中度、显著强化。随后测量病灶动脉期、静脉期CT肺减影图像的灌注值(∆Husub)。采用McNemar检验和kappa检验分别评估动、静脉期∆Hu等级和减影彩图视觉评估碘分布等级的差异和一致性。采用配对t检验对比动、静脉期普通CT的∆Hu和减影CT的∆Husub之间的差异。结果:共纳入34位患者(37个病灶)。3位观察者所测量数据的一致性良好。动、静脉期∆Hu分级和CT减影彩图视觉评估病灶碘分布等级之间无显著差异,且两者一致性好。动、静脉期无减影CT的∆Hu和有减影CT的∆Husub之间的差异均无统计学意义。结论:CT肺减影成像在不延长扫描时长的前提下,简化阅片时对病灶进行测量和计算的步骤,有助于提高诊断效率。

     

    Abstract: Objective: This study aimed to explore the clinical use of the chest computed tomography (CT) subtraction technique for evaluating the degree of chest mass enhancement. Methods: Patients with suspected chest masses who underwent contrast-enhanced chest CT were retrospectively enrolled. Contrast-enhanced CT used was performed using lung subtraction. Subtraction images were reconstructed, and color fusion images of the iodine distribution in the chest masses in the arterial and venous phases were obtained after subtraction. The net enhancement value (∆Hu) was measured and calculated. The enhancement degree were divided into mild (∆Hu < 20 HU), moderate (∆Hu 20~40 HU), and significant (∆Hu > 40 HU). The CT subtraction iodine maps were visually evaluated. The net perfusion value (∆Husub) of CT lung subtraction iodine maps in arterial phase and venous phase was measured. McNemar and kappa tests were used to evaluate the difference and consistency of ∆Hu and ∆Husub degrees, respectively. The paired t test was used to compare the differences between ∆Hu and ∆Husub. Results: This study included 34 patients (37 lesions). Data measured by the three observers were in good agreement. The ∆Hu and ∆Husub degrees had no significant difference, but had good consistency. No significant differences were observed between ∆Hu and ∆Husub in the arterial and venous phases. Conclusion: Lung subtraction CT imaging can simplify the steps of image reading and report writing by reducing the measurement and calculation times for lung lesions without increasing scanning time, which contributes to improving the efficiency of diagnosis.

     

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