双源CT双能量TNC技术图像质量与诊断肝细胞癌效能分析*

doi:10.3969/j.issn.1672-5069.2024.06.029

摘要/Abstract

摘要： 目的分析双源CT双能量真实平扫(TNC)技术图像质量和诊断肝细胞癌(HCC)的效能。方法 2020年1月～2023年1月我院收治的85例肝占位性病变患者,均接受双源CT双能量增强扫描,获取TNC和虚拟平扫(VNC)图像,计算图像信噪比(SNR)和对比噪声比(CNR)。采用5分法评估图像质量。结果在85例肝占位性病变患者中,经病理学检查诊断HCC 48例,肝局灶性结节增生(FNH)23例和肝血管瘤(HH)14例;HCC病灶TNC图像肝脏病灶和同层面右侧竖脊肌CT值标准差(SD)和辐射剂量分别为(7.9±1.8)HU和(5.9±0.6)mSv,显著大于VNC图像【分别为(6.7±1.3)HU和(3.6±0.7)mSv,P<0.05】,而SNR为(5.4±1.6),显著低于VNC图像【(6.5±1.7),P<0.05】;HCC、FNH和HH病灶TNC图像的SD和辐射剂量均显著大于VNC图像(P＜0.05),而SNR显著低于VNC图像(P＜0.05);HCC病灶TNC和VNC图像CT值显著大于FNH或HH病灶(P＜0.05);HCC病灶TNC图像质量主观评分显著高于VNC图像(P＜0.05);TNC图像诊断HCC的敏感度为89.6%、特异度为91.9%、准确率为90.6%,显著优于VNC诊断(分别为72.9%、78.4%和75.3%,P＜0.05)。结论虽然双源CT双能量增强扫描辐射剂量稍大,但TNC图像质量好,诊断HCC的准确率高,临床应用价值大。

关键词: 肝细胞癌, 双源CT双能量扫描, 真实平扫, 虚拟平扫, 图像质量, 诊断

Abstract: Objective The purpose of this study was to investigate the image quality and diagnostic efficacy of dual-source CT dual-energy true non-contrast enhanced (TNC) technique in patients with hepatocellular carcinoma(HCC). Methods 85 patients with intrahepatic space-occupying lesions were admitted to our hospital between January 2020 and January 2023, and all underwent dual-source CT dual-energy enhanced scanning to obtain the TNC and virtual non-contrast enhanced (VNC) imaging, signal to noise ratio (SNR) and contrast noise ratio (CNR). The imaging quality was subjectively evaluated by five scores. Results Out of the 85 patients with intrahepatic space-occupying lesions, the histopathological examination diagnose HCC in 48 cases, focal nodular hyperplasia (FNH) in 23 cases and hepatic hemangioma (HH) in 14 cases; the standard deviation (SD) of CT value of the hepatic lesion/right erector spinalis muscle at same level and the radiation dose in TNC-showed HCC foci were(7.9±1.8)HU and (5.9±0.6)mSv, both significantly greater than [(6.7±1.3)HU and (3.6±0.7)mSv, respectively, P<0.05] showed by VNC, while the SNR was (5.4±1.6), much smaller than [(6.5±1.7), P<0.05] showed by VNC; all the SD and the radiation dose in HCC, FNH and HH foci by TNC imaging were significantly greater than by VNC imaging(P＜0.05), while the SNR was much lower than by VNC imaging (P＜0.05); the CT values of HCC lesions by both TNC and VNC were greater than in FNH or HH foci (P＜0.05); the subjective image quality score of HCC lesions by TNC was superior to by VNC imaging (P＜0.05); the sensitivity, specificity and accuracy of TNC imaging in diagnosing HCC were 89.6%, 91.9% and 90.6%, much superior to 72.9%, 78.4% and 75.3%, respectively (P＜0.05) by VNC imaging. Conclusion In dual-source CT dual-energy enhanced scan, although TNC images have higher radiation dose, the quality of TNC images is higher than that of VNC images, and the accuracy of TNC images in diagnosing hepatocellular carcinoma is higher, which has certain guiding value for clinical diagnosis of hepatocellular carcinoma.

Key words: Hepatocellular carcinoma, Dual-source CT dual-energy, True non-contrast enhanced, Virtual non-contrast enhanced, Image quality, Diagnosis

杨佳欣, 杨紫郡, 陈卫. 双源CT双能量TNC技术图像质量与诊断肝细胞癌效能分析^*[J]. 实用肝脏病杂志, 2024, 27(6): 915-918.

Yang Jiaxin, Yang Zijun, Chen Wei. Image quality and diagnostic efficacy of dual-source CT dual-energy TNC technique in patients with hepatocellular carcinoma[J]. Journal of Practical Hepatology, 2024, 27(6): 915-918.

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双源CT双能量TNC技术图像质量与诊断肝细胞癌效能分析^*

Image quality and diagnostic efficacy of dual-source CT dual-energy TNC technique in patients with hepatocellular carcinoma

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