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目的分析小型猪早期肝泡状棘球蚴病(hepatic alveolar echinococcosis,HAE)模型的能谱CT影像表现,并确定最佳单能图像。方法贵州小型猪9头,行肝脏穿刺接种泡球蚴头节混悬液,接种25周经超声检查确认泡状棘球蚴接种成功的小型猪行64排能谱CT平扫和动脉期、门脉期、静脉期三期增强扫描,记录病灶大小、形态和内部结构。图像分析以5keV为间距,选取40~140keV的21个单能图像,以肝实质为背景,测量三期HAE病灶图像的信噪比(signal to noise ratio,SNR)、对比噪声比(contrast to noise ratio,CNR)和噪声,并绘制图像噪声、SNR和CNR散点图,确定三期HAE最佳单能量图像。在碘基图像上测量三期正常肝实质、HAE病灶及病灶边缘区域碘值并进行比较。检查结束后处死小型猪,对肝脏病变区域行组织病理学检查。结果小型猪早期HAE模型成功建模4头,均为单发病灶;CT平扫表现为类圆形囊性病灶,囊壁呈环形钙化,囊内呈水样密度,2个病灶囊内可见颗粒样钙化,病灶直径7.15~33.25mm;增强后病灶无明显强化,病灶边缘区呈低强化;三期散点图显示在70keV水平上早期HAE病灶的SNR和CNR均较高,噪声较低;病灶边缘区和正常肝实质在动脉期[(0.479±0.235)、(1.139±0.859)g/L]、门脉期[(4.804±0.895)、(17.464±1.078)g/L]和静脉期[(6.763±0.619)、(22.113±1.054)g/L]的碘值比较差异均有统计学意义(P<0.01);HAE病灶在三期扫描间的碘值比较差异无统计学意义(P>0.05);组织病理学检查可见单个或多个囊泡样红染结构,病灶边缘区纤维组织增生,同时可见微血管及多种炎细胞浸润。结论早期小型猪HAE病灶在能谱CT图像上有一定特征性表现,70keV图像是肝动脉期、门脉期及静脉期观察小型猪早期HAE病灶的最佳单能图像。
Objective To analyze the spectral CT features of HAE in miniature pigs and to determine the best unilaterally possible images. Methods Nine Guizhou miniature pigs were subjected to hepatic puncture inoculation with the suspension of the first part of the cysticercus spp. After being inoculated for 25 weeks, the small swine inoculated with Echinococcus granulosus was confirmed by 64-row EDCT and arterial phase, Pulse, venous three enhanced scanning, recording lesion size, shape and internal structure. Image analysis The 21 single-energy images of 40-140 keV were taken at 5 keV intervals. The signal to noise ratio (SNR) of the third-stage HAE lesion was measured against the background of liver parenchyma. The contrast to noise ratio, CNR) and noise, and plot the image noise, SNR and CNR scattergrams to determine the best single-energy image of the third-stage HAE. Three phases of normal liver parenchyma, HAE lesion and marginal zone of iodine were measured on iodine-based images and compared. Small pigs were sacrificed at the end of the examination, and histopathological examination of the liver lesion area was performed. Results The early HAE model of miniature pig was successfully modeled with 4 lesions, all of which were single lesions. The CT scan showed round cystic lesions with circular calcification of the capsule wall and water-like density in the capsule. Like calcification, the diameter of the lesion was 7.15 ~ 33.25mm; no significant enhancement of the lesion and low enhancement of the edge of the lesion; the third-period scatter plot showed that the early SNR of HAE and CNR were higher and the noise was lower at 70keV; (0.479 ± 0.235) and (1.139 ± 0.859) g / L] in portal phase and normal liver parenchyma in portal phase [(4.804 ± 0.895) and (17.464 ± 1.078) g / L] 6.763 ± 0.619, and (22.113 ± 1.054) g / L], respectively (P <0.01). There was no significant difference in iodine value between the three stages of HAE lesions (P> 0.05 ); Histopathological examination showed single or multiple vesicle-like red dye structure, the edge of the lesion fibrous tissue proliferation, while visible microvascular and a variety of inflammatory cell infiltration. Conclusion HAE lesions of early miniature piglets have some characteristic features on the CT images. 70keV images are the best single-energy images of the early HAE lesions in the mini-pigs in the hepatic artery, portal and venous phases.