摘要
目的探讨单源双能CT最佳单能量成像技术在检查直肠癌供血动脉中的应用价值。方法回顾性分析2012年7月至2014年7月大连医科大学附属第-医院收治的33例直肠癌患者的临床资料,通过单源双能CT扫描,采用混合能量和最佳单能量两种模式重建肿瘤供血动脉。由两位观察者盲法分别对两种图像直肠癌细小供血动脉进行5分制主观图像质量评分。对评分结果的-致性进行k检验,对两种图像的主观评分进行t检验;由两位观察者分别测量两种图像直肠癌细小供血动脉和臀部肌肉的CT值以及图像噪声值,并计算对比噪声比(CNR),采用组内相关系数(ICC)检验两位观察者对两种图像测量数据的-致性,并采用独立样本Mann—WhitneyU检验对两种重建模式的直肠癌细小供血动脉cT值、图像噪声值以及CNR进行比较。结果33例患者中肠系膜下动脉均参与肿瘤供血;其中4例患者右侧直肠下动脉参与供血,2例患者双侧直肠下动脉参与供血。发现血管变异情况:8例患者左结肠动脉与乙状结肠动脉共干,4例患者左结肠动脉直接起自肠系膜上动脉,1例患者左结肠动脉缺如。两位观察者对直肠癌细小供血动脉混合能量图像评分0、1、2、3、4分分别为0、13、13、5、2例和0、11、14、6、2例;最佳单能量评分0、1、2、3、4分分别为0、0、7、7、19例和0、0、6、9、18例。两位观察者对混合能量和最佳单能量直肠癌细小供血动脉图像评分结果-致性很好(K=0.864,0.897);混合能量与最佳单能量图像细小供血动脉图像主观质量评分分别为(1.9±0.9)分、(3.4±0.8)分,两者比较,差异有统计学意义(Z=-5.21,P〈0.05)。最佳单能量图像的直肠癌细小供血动脉的主观评价优于混合能量图像。混合能量与最佳单能量直肠癌细小供血动脉CT值、臀部肌肉cT值、图像噪声值及CNR的ICC值�
Objective To explore the application value of optimal energy imaging technique of monoener- getie dual-energy computed tomography (DECT) in feeding arteries examination of rectal cancer. Methods The clinical data of 33 patients with rectal cancer who were admitted to the First Affiliated Hospital of Dalian Medical University from July 2012 to July 2014 were analyzed retrospectively. The polyehromatic and monochromatic images of feeding arteries of tumors were reconstructed and evaluated using a subjective image quality score of 5-point scale by 2 observers. The consistency and scores of evaluation were analyzed by the K test and Mann- Whitney U test. The CT value of feeding arteries of tumors and hip muscle, image noise and contrast to noise ratio (CNR) were measured and calculated by 2 observers, and were compared by the independent sample t test. The consistency of data between the 2 observers were measured by the intra-class correlation coefficients (ICC). Results Inferior mesenteric arteries were contributor of blood supply of tumors in all the 33 patients, including4 cases with right inferior rectal artel): as contributor of Mood supply of tumors, 2 cases with bilateral inferior rectal artery. Among patients with abnonnal blood vessels, there were 8 patients with left colic artery and sigmoid artery having common trunk, 4 patients with lel) colic artery originated from Inferior mesenteric artery, 1 patient with absenee of left colic artery. The 0-, 1-, 2-, 3-, 4- seore polychromatic image quality of feeding arteries of tmnnrs were detected in 0, 13, 13, 5, 2 patients an,I 0, 11 , 14, 6, 2 patients by 2 observers, respeetively. The 0-, 1 -, 2-, 3-, 4- score monochromath: image quality of feeding arteries of tumors were detected in 0, 0, 7, 7, 19 patients and 0, 0, 6, 9, 18 patients by 2 observers, respectively. Good interobserver agreement was fbund tor the evaluation of subjective scores (K = 0. 864, 0. 897). The subjective scores of image quality of feeeding arteries in the polychrom
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2015年第9期741-745,共5页
Chinese Journal of Digestive Surgery
基金
基金项目:国家自然科学基金(4993192)