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目的 CT能谱成像对肝脏局灶性病变鉴别诊断价值进行探讨和研究。方法 40例肝脏局灶性病变患者,对患者的临床资料进行回顾式分析,患者均采用64层能谱CT进行能谱模式扫描,获取患者的动脉期和门静脉期的能谱系列图像,测量患者的病灶、正常肝组织和腹主动脉的能谱参数,同时计算患者在不同能量水平下病灶-肝脏对比噪声比(CNR)、标准化碘浓度(NIC)、病灶与正常肝组织碘浓度比值(LNR)、病灶动脉期和门静脉期碘浓度的差异(ICD)等。结果通过对患者的诊断结果进行分析,患者的病灶-肝脏对比噪声比会随着单光子能量的增加量减小,但在部分能量点除外,患者动脉期最佳的CNR为(3.57±1.09),NIC为(2.94±0.52)g/L,LNR为(1.06±0.14),患者的门静脉期最佳的CNR为(1.78±0.26),NIC为(0.51±0.16)g/L,LNR为(1.02±0.13),ICD为(0.36±0.09)g/L,患者在动脉期病灶与正常肝组织碘浓度比值时具有较高的特异性和敏感性。结论在对肝脏局灶性病变患者的诊断过程中,CT能谱成像具有较高的准确性,在临床上具有极为重要的意义,值得今后推广和应用。
Objective CT spectral imaging of the differential diagnosis of focal liver lesions to explore and study. Methods The clinical data of 40 patients with focal liver lesions were retrospectively analyzed. The patients were scanned by energy spectrum with 64-layer spectral CT, and the images of energy spectrum of the patients in the arterial and portal venous phases were obtained. (CNR), normalized iodine (NIC), ratio of iodine concentration in lesion to normal liver tissue (LNR) at different energy levels were calculated at the same time, and the energy spectral parameters of normal liver tissue and abdominal aorta were calculated. ), Differences in the concentration of iodine between the arterial and portal venous phases (ICD). Results By analyzing the patient’s diagnosis results, the lesion-liver contrast-to-noise ratio decreased with the increase of single-photon energy, except for some energy points, the best CNR in arterial phase was (3.57 ± 1.09) (2.94 ± 0.52) g / L for NIC and LNR (1.06 ± 0.14) respectively. The best CNR was 1.78 ± 0.26 in portal vein and 0.51 ± 0.16 g / L in NIC. The LNR was (1.02 ± 0.13) and ICD (0.36 ± 0.09) g / L, respectively. The patients had high specificity and sensitivity in the ratio of iodine concentration between arterial phase and normal liver tissue. Conclusion In the diagnosis of focal liver lesions in patients with CT spectral imaging with high accuracy, clinically very important and worth the promotion and application in the future.