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目的探讨CT动脉单期能谱成像定量分析在鉴别肾上腺腺瘤与转移瘤中的价值。方法回顾性分析2011年6月至2012年3月间行能谱CT检查并经病理或随访确诊的肾上腺腺瘤31例,转移瘤16例,并将10例正常肾上腺作为对照组进行研究。选择动脉期能谱成像对腺瘤组、转移瘤组及对照组进行单能量重建及物质定量分析,在碘-脂基图上定量测定碘、脂含量,计算能谱曲线的斜率(λHU)并测量混合能量图像上相应部位的CT值。通过SPSS 17.0统计分析软件,采用均数±标准差进行描述性分析,并进行方差分析。结果单因素方差分析证实腺瘤组、转移瘤组及对照组两两之间在碘、脂含量及λHU差异均存在统计学意义(F碘(腺瘤VS转移瘤)=1.25,F碘(腺瘤VS对照)=0.48,F碘(转移VS对照)=-0.77;F脂(腺瘤VS转移瘤)=12.83,F脂(腺瘤VS对照)=6.12,F脂(转移VS对照)=-6.71;FλHU(腺瘤VS转移瘤)=0.43,FλHU(腺瘤VS对照)=0.18,FλHU(转移VS对照)=-0.26,P值均<0.01),且腺瘤组(4.66±0.89和997.95±4.32)在碘、脂含量之间均高于转移瘤组(3.40±0.98和985.12±6.52)(F碘(腺瘤VS转移瘤)=1.25,F脂(腺瘤VS转移瘤)=12.83,P值均<0.001);对于混合能量下的CT值,腺瘤组、转移瘤组分别与对照组间差异存在统计学意义(FCT(腺瘤VS对照)=15.35,FCT(转移VS对照)=14.06,P值均<0.05),而腺瘤组与转移瘤组间差异无统计学意义(FCT(腺瘤VS转移瘤)=1.29,P=0.83)。结论动脉单期能谱扫描单能量重建及物质定量分析对于区分肾上腺肿瘤的良恶性具有一定的临床价值。
Objective To investigate the value of single-phase spectral imaging in the diagnosis of adrenal adenomas and metastases. Methods 31 cases of adrenal adenomas confirmed by pathological or follow-up CT scan between June 2011 and March 2012 were retrospectively analyzed. Sixteen cases of metastases were retrospectively analyzed. Ten cases of normal adrenal gland were used as control group. Single-energy reconstruction and quantitative analysis of substances in the adenoma group, metastatic tumor group and control group were carried out by arterial energy spectrum imaging. The iodine and lipid contents were quantified on the iodine-lipid diagram and the slope (λHU) of the energy spectrum curve was calculated Measure the CT value of the corresponding site on the mixed energy image. Through SPSS 17.0 statistical analysis software, descriptive analysis using mean ± standard deviation and analysis of variance. Results One-way analysis of variance showed that there was statistically significant difference in iodine, lipid contents and λHU between adenomas, metastases and controls (F iodine (adenoma VS metastases) = 1.25, F iodine Tumor VS control) = 0.48, F iodine (metastasis VS control) = -0.77; F fat (adenoma VS metastases) = 12.83, Fiprolein 6.71; FλHU = 0.43, FλHU = 0.18, FλHU = -0.26, both P <0.01), and adenomas (4.66 ± 0.89 and 997.95 ± 4.32) were higher than those in the metastatic tumor group (3.40 ± 0.98 and 985.12 ± 6.52) (F iodine (adenoma VS metastatic tumor) = 1.25, F lipid (adenoma VS metastatic tumor) = 12.83, P <0.001). For the CT values at mixed energy, there were statistically significant differences between the adenoma group and the metastatic tumor group and the control group (FCT (adenoma vs control) = 15.35, FCT (metastasis vs control) = 14.06, P <0.05). There was no significant difference between adenoma group and metastasis group (FCT (adenoma VS metastasis) = 1.29, P = 0.83). Conclusion Single-phase energy spectrum single-energy tomography reconstruction and quantitative analysis of the material for the differentiation of benign and malignant adrenal tumors have some clinical value.