摘要
目的采用CT能谱成像术前评估肾透明细胞癌核分级,以评估术前肾透明细胞癌的恶性程度,指导手术治疗。资料与方法回顾性分析经手术病理证实的40例肾透明细胞癌肿块的能谱特征,所有患者术前均采用64层CT能谱的能谱扫描模式进行扫描,获得动脉期和髓质期的能谱系列图像。比较不同分级肾透明细胞癌的能谱特征参数及能谱曲线,并与病理结果进行对照。结果 40例患者中,I、II、III级分别有13例、15例、12例。肾透明血细胞癌I、II、III级动脉期70 keV CT值比值分别为1.17±0.25、0.84±0.85、0.64±0.19(F=23.697,P<0.05),髓质期分别为0.83±0.12、0.64±0.07、0.54±0.08(F=30.975,P<0.05);动脉期碘浓度比值分别为1.19±0.40、0.60±0.10、0.25±0.94(F=32.932,P<0.05),髓质期分别为0.69±0.18、0.43±0.94、0.26±0.51(F=28.673,P<0.05)。肾透明血细胞癌I、II、III级动脉期能谱曲线斜率分别为4.00±1.24、2.16±0.95、0.92±0.64(F=23.392,P<0.05),髓质期分别为3.54±1.20、2.70±0.71、1.20±0.44(F=24.272,P<0.05)。各级肾透明细胞癌间动脉期和髓质期水浓度差异均无统计学意义(P>0.05)。结论 CT能谱成像扫描参数单能量CT值、能谱曲线斜率、碘基值在肾透明细胞癌不同核分级间有显著差异,有望为术前治疗方案的选择提供依据。
Purpose CT spectroscopy imaging was used in the preoperative differentiation evaluation of renal clear cell carcinoma, to access its malignant degree preoperatively, and to guide the operation treatment. Materials and Methods The spectral characteristics of 40 patients with renal clear cell carcinoma （RCCC） were analyzed retrospectively, all the RCCC patients underwent gemstone spectral imaging （GSI） scans, to obtain spectral serial images for the arterial phase and medulla phase. Spectral characteristic parameters and spectrum curve between different grades of renal cell carcinoma was compared, and the results wele compared with pathology. Results Among the 40 cases of patients, carcinoma of grade Ⅰ, Ⅱ and Ⅲ were 13 cases, 15 cases and 12 cases respectively. CT value ratio of renal clear cell carcinoma of grade 1, Ⅱ and Ⅲ under 70 keV were 1.170±0.25, 0.84±0.85 and 0.644±0.19 （F=23.697, P〈0.05） in arterial phase and 0.83±0.12, 0.644±0.07 and 0.54±0.08 （F=30.975, P〈0.05） in medulla phase; iodine concentration ratio was 1.19±0.40, 0.60±0.10 and 0.25±0.94 （F=32.932, P〈0.05） in arterial phase, and 0.69± 0.18, 0.43± 0.94 and 0.26 4±0.51 （F=28.673, P〈0.05） in medulla phase. Spectrum curve slope of renal clear cell carcinoma of grade I, II, II1 in arterial phase was 4.00± 1.24, 2.16±0.95 and 0.92±0.64 （F=23.392, P〈0.05）, and 3.54 ± 1.20, 2.70± 0.71 and 1.20± 0.44 （F-24.272, P〈0.05） in medulla phase. Differences of water concentration in arterial and medulla phase between renal clear cell carcinoma with different grade were not statistically significant（ P〉0.05）. Conclusion The differences of CT value, energy spectrum curve slope, iodine value under CT spectroscopy single energy imaging between renal clear cell carcinoma with different nuclear grade were statistically significant, which can be expected to provide the basis for preoperative therapy selection.
出处
《中国医学影像学杂志》
CSCD
北大核心
2014年第9期681-685,共5页
Chinese Journal of Medical Imaging
关键词
癌
肾细胞
体层摄影术
X线计算机
能谱成像
肿瘤分级
Carcinoma, renal cell
Tomography, X-ray computed
Spectral imaging
Neoplasm grading
