摘要
目的采用双能量CT(DECT)后处理电子云密度/等效原子系数(Rho/Z)模式实现对肾周脂肪粘连(APF)的有效识别及混合现实(MR)结果发布。方法前瞻性搜集本院泌尿外科于2020年6月至2021年1月拟行保留肾单位手术(NSS)的T1期(RENAL评分≥7分)肾癌患者76例,随机分为MR成像组(记作:A组,n=37)和常规CT图像组(记作:B组,n=39),所有患者术前均行DECT肾脏三期动态增强扫描,并将A组生成的DICOM格式文件传至DECT后处理工作站,选取Rho/Z模式对肾周脂肪情况进行分析,分析结束后将数据导入至全息可视化三维(3D)重组软件,分别进行3D分割、3D建模及3D场景展示,并将最终生成的立体光刻(STL)文件进行MR结果发布;B组进行常规薄层图像重组,并以传统胶片的形式进行结果发布。对两组患者的一般人口学特征、围手术期结果进行比较。结果两组患者的一般人口学特征未见明显差别;采用DECT后处理Rho/Z模式可有效识别APF的发生,并通过MR技术可实现有效显示;同时A组在成功实施NSS例数上明显多于B组(P<0.05),A组在手术时间、热缺血时间及估计失血量均少于B组(P均<0.001)。结论基于DECT后处理Rho/Z模式功能可有效预测APF的发生,并采用MR技术对APF进行有效成像发布,可显著提高肾癌行NSS的成功率、缩短手术时间、热缺血时间及减少估计失血量。
Objective The dual-energy CT(DECT)post-processing electron cloud density/effective atomic number(Rho/Z)mode is adopted to realize the effective identification of adherent perinephric fat(APF)and the release of mixed reality(MR)results.Methods 76 patients with stage T1 renal cell carcinoma undergoing nephron sparing surgery(NSS)in our hospital from June 2020 to January 2021 were prospectively collected and were randomly divided into MR imaging group(namely group A,n=37)and conventional CT imaging group(namely group B,n=39).All patients underwent three-phase dynamic contrast-enhanced renal DECT,and the DICOM files generated by group A was transmittedto the DECT post-processing workstation.The Rho/Z mode was selected for analysis.After the analysis,the data were imported into the holographic visualization three-dimensional(3 D)reconstruction software for 3 D segmentation,3 D modeling and 3 D scene display,and the final STL file was released for MR.Group B were reconstructed with conventional CT thin-layer image,and the results were released in the traditional CT film.The general demographic characteristics and perioperative results of thegroups A and B were compared.Results There was no significant difference in general demographic characteristics between the two groups;the occurrence of APF could be effectively identified by DECT post-processing Rho/Z mode,and APF could be effectively displayed by MR technology.The number of successful implementation of NSS in group A was apparently more than that in group B(P<0.05),and the operation time,blood loss time and estimated blood loss in group A were less than those in group B(all P<0.001).Conclusion Based on the function of Rho/Z mode of DECT post-processing,the occurrence of APF can be effectively predicted,and the effective imaging of APF by MR technology can significantly improve the success rate of NSS,shorten the operation time,warm ischemia time and reduce the estimated blood loss.
作者
李冠
达建萍
黄伟
钟晶
钱瑶
曹志强
李欣阳
董杰
LI Guan;DA Jianping;HUANG Wei(Department of Radiology,General Hospital of Eastern Theater Command,Nanjing,Jiangsu Province 210002,P.R.China)
出处
《临床放射学杂志》
北大核心
2021年第10期2010-2015,共6页
Journal of Clinical Radiology
