摘要
目的探讨单源双能CT平扫综合分析对不同成因良性浆膜腔积液的诊断价值,以准确判断积液成因,指导临床治疗。资料与方法回顾性分析47例（69个浆膜腔）行单源双能CT平扫能谱成像,并经临床证实为良性浆膜腔积液的影像资料,按成因不同分为肝硬化组（19个浆膜腔）、心力衰竭组（21个浆膜腔）、结核组（14个浆膜腔）及炎症组（15个浆膜腔）。应用能谱成像综合分析平台,测量并比较4组平扫图像的常规混合能量CT值、不同单能量条件下CT值、有效原子序数（Effective-Z）值及不同基物质对浓度值,并计算曲线斜率。评估对4组均有鉴别价值的参数对非炎性（肝硬化组、心力衰竭组）与炎性（结核组、炎症组）浆膜腔积液的鉴别效能,得出相应界值。结果 4组浆膜腔积液的混合能量CT值差异无统计学意义（P〉0.05）;4组浆膜腔积液40 keV条件下CT值、曲线斜率、Effective-Z值及钙（水）、碘（水）、水（脂）浓度肝硬化组〈心力衰竭组〈结核组〈炎症组,组间差异均有统计学意义（P〈0.05）;脂（水）浓度肝硬化组〉心力衰竭组〉结核组〉炎症组,组间差异均有统计学意义（P〈0.05）;50~140 keV条件下CT值、水（钙）、水（碘）浓度在部分组间差异有统计学意义（P〈0.05）。40 keV CT值对炎性与非炎性组浆膜腔积液诊断效能最高,CT值≥24.23 HU为诊断炎性浆膜腔积液的界值,敏感度为96.6%,特异度为97.5%。结论单源双能CT平扫能谱成像综合分析平台中的低能量图像（40 keV）、曲线斜率、Effective-Z及基物质对均能有效区分不同成因的良性浆膜腔积液,为良性浆膜腔积液成因的鉴别诊断提供了多参数方法。
Purpose To investigate the value of plain scan comprehensive analysis of single source dual-energy CT in differentiating benign serous cavity effusion with different origin, in order to accurately determine the cause of the effusion and guide clinical treatment. Materials and Methods Forty-seven cases（69 benign serous cavities） underwent single source dual-energy CT gemstone spectral imaging（GSI） scan were retrospectively analyzed and divided into four groups according to different origins： liver cirrhosis group（19 serous cavities）, heart failure group（21 serous cavities）, tuberculosis group（14 serous cavities） and inflammation group（15 serous cavities）. The conventional mixing energy CT value, monochromatic images, the effective atomic number（Effective-Z） and different base material of concentration values were measured and the slope of the curve was calculated based on the GSI comprehensive analysis platform. Compared the above parameters among all groups and calculated the cut-off value so as to distinguish the property of serous cavity effusion between the inflammatory disease（tuberculosis group and inflammation group） and non-inflammatory disease（liver cirrhosis group and heart failure group）. Results The conventional mixing energy CT value and the CT value of 100 to 140 keV among 4 groups had no significant difference（P〈0.05）. The CT value of 40 keV, the slope of the curve, the Effective-Z, and the calcium（water）, iodine（water） and water（fat） concentration had significant difference among 4 groups（P〈0.05）, and the order from small to large was liver cirrhosis group heart failure group tuberculosis group inflammation group. The fat（water） concentration had significant difference among 4 groups（P〈0.05）, and the order from large to small was liver cirrhosis group heart failure group tuberculosis group inflammation group. The CT value of 50 to 140 keV, the water（calcium） and water（iodine） concentration in some groups had significant difference among 4 groups（P〈0.05）. It showed that the 40 keV CT value was the best parameter to distinguish inflammatory and non-inflammatory diseases. The best cut-off CT value was ≥ 24.23 HU, the sensibility was 96.6%, and the specificity was 97.5%. Conclusion Single source dual-energy CT plain scan GSI comprehensive analysis platform included the low energy image（40 keV）, slope of the curve, Effective-Z and base material of concentration values can effectively distinguish different origins of benign serous cavity effusion and provide a multi parameter method.
出处
《中国医学影像学杂志》
CSCD
北大核心
2016年第6期442-445,450,共5页
Chinese Journal of Medical Imaging
基金
国家自然科学基金项目(81470078)
关键词
心包积液
胸腔积液
腹腔
浆膜
肝硬化
心力衰竭
结核
炎症
体层摄影术
X线计算机
图像处理
计算机辅助
诊断
鉴别
Pericardial effusion
Pleural effusion
Abdominal cavity
Serous membrane
Liver cirrhosis
Heart failure
Tuberculosis
Inflammation
Tomography
X-ray computed
Image processing
computer-assisted
Diagnosis
differential
