摘要
目的分析能谱CT影像在儿童胃间质瘤伴肝脏转移的诊断中的应用价值。方法回顾性分析1例经手术证实的胃间质瘤伴肝脏转移患儿的临床和能谱CT资料,并结合文献对其分析。结果能谱CT能清晰显示患儿原发胃间质瘤和肝脏转移病灶。增强后动脉期显示低能量条件下(70 keV以下)原发病灶、正常胃壁与肝脏转移灶能谱衰减曲线的斜率及走行基本吻合,高能量条件下(80 keV以上)三者稳合更高。直方图显示原发病灶与正常胃壁重叠程度最高,原发病灶和肝脏转移灶重叠程度部分吻合。散点图显示原发病灶和正常强化胃壁散点分布比较接近。胃间质瘤在动脉期及门静脉期能谱衰减曲线走行均位于正常胃壁的上方。病理诊断结果为胃间质瘤伴肝脏转移。结论能谱CT曲线斜率以及直方图和散点图重叠程度能准确判断儿童胃间质瘤原发灶和转移灶是否具有同源性,根据不同单能量能谱斜率走行对照可初步进行肿瘤的分级。
Objective To explore the diagnostic value of energy spectral CT in child with interstitialoma of stomach and hepatic metastasis. Methods We retrospectively reviewed the clinical and energy spectral CT data of a patient with interstitialoma of stomach and hepatic metastasis, and literatures were reviewed. Results Energy spectral CT could clearly show both primary interstitialoma of stomach and hepatic metastasis. In the arterial phase(below the 70 keV), the slopes of energy spectral attenuation curves were basicly similar among the primary interstitialoma of stomach, normal gastric wall, and hepatic metastasis;while, in the high-energy(above the 80 keV), the three slopes were much more similar. The histogram showed that the energy spectral densities of the primary interstitialoma and the normal gastric wall highly overlapped.However, in scatterplot images, the distribution of energy spectral densities were partially overlapped. The localization of the energy spectral attenuation curves in the arterial and vein phase of the stomach interstitialoma were above the normal gastric wall. The gastric-stromal tumor with hepatic metastasis was confirmed by pathological analysis. Conclusion The energy spectral CT can exactly identify the homology between the primary and metastasis by the degree of overlapping in spectral curve, histogram, and scatterplot, and can be used to preliminary classify the tumor by comparing monoenergetic spectral attenuation curves.
作者
侯志彬
赵丽
王春祥
HOU Zhibin;ZHAO Li;WANG Chunxiang(Department of Imaging, Tianjin Children's Hospital, Tianjin 300134, China;Department of Pathology, Tianjin Children’s Hospital, Tianjin 300134, China)
出处
《国际医学放射学杂志》
北大核心
2019年第5期602-605,共4页
International Journal of Medical Radiology
关键词
胃间质瘤
转移
能谱
体层摄影术
X线计算机
儿童
Stomach interstitialoma
Metastasis
Energy spectral
Tomograthy,X-ray computed
Children
