摘要
目的探究双源电子计算机断层扫描(CT)双能量虚拟平扫对结直肠良恶性肿瘤的鉴别诊断价值。方法选择60例临床疑诊结直肠肿瘤性病变患者,行腹部CT平扫及动、静脉期双能量增强扫描,获取虚拟平扫图像,比较真实平扫与虚拟平扫辐射剂量、图像质量情况,以病理诊断结果为“金标准”,评价双能量虚拟平扫的诊断效能。结果单期真实扫描辐射CT剂量指数(CTDvol)、剂量长度乘积(DLP)、有效剂量(ED)水平均显著低于单期虚拟扫描(P<0.05),常规三期扫描辐射剂量指标水平均显著高于双能双期扫描(P<0.05);真实平扫及动、静脉期虚拟平扫图像质量比较差异无统计学意义(P>0.05);60例疑诊患者经病理诊断检出良性肿瘤24例,恶性肿瘤36例;结直肠癌23例,乙状结肠癌9例,直肠癌3例,发生淋巴结转移15例;CT真实平扫+动态增强扫描检出良性肿瘤25例,恶性肿瘤35例,淋巴结转移检出率80.00%(12/15);双源CT双能量虚拟扫描+增强扫描检出良性肿瘤36例,恶性肿瘤24例,淋巴结转移86.67%(13/15);双源CT双能量虚拟平扫+增强扫描诊断结直肠癌良恶性肿瘤的诊断效能为:灵敏度94.44%、特异度91.67%、准确率93.33%、阳性预测值94.44%、阴性预测值91.67%。结论双源CT双能量虚拟平扫用于诊断结直肠良恶性肿瘤的辐射剂量较常规平扫更低,可保证图像质量,具有更高诊断效能,临床应用价值高。
Objective To investigate the differential diagnosis value of dual-source computed tomography(CT) dualenergy virtual non-contrast on benign and malignant colorectal tumors.Methods Sixty patients with clinically suspected colorectal tumors were enrolled.The abdominal CT plain scan and dual-energy enhanced scan of arterial and venous phases were performed to obtain the images of virtual noncontrast.The radiation dose and image quality were compared between actual plain scan and virtual non-contrast.The diagnostic efficiency of dual-energy virtual non-contrast was evaluated by taking pathological diagnostic results as the gold standa rds.Results The radiation CT dose index(CTDvol),dose length product(DLP),and effective dose(ED) of single-phase actual scan were significantly lower than those single-phase virtual scan(P<0.05),and the radiation dose indexes of the conventional threephase scan we re significantly higher than those of dual-energy dual-phase scan(P<0.05).There was no significa nt difference in the image quality between actual plain scan and virtual non-contrast of a rterial and venous phases(P>0.05).Among 60 suspected patients diagnosed by pathological diagnosis,there were 24 cases of benign tumors,36 cases of malignant tumors,23 cases of colorectal cancer,9 cases of sigmoid colon cancer,and 3 cases of rectal cancer,with 15 cases of lymph node metastasis.There were 25 cases of benign tumors and 35 cases of malignant tumors detected by CT actual plain scan+dynamic enhanced sca n,and the detection rate of lymph node metastasis was 80.00%(12/15).There were 36 cases of benign tumors and 24 cases of malignant tumors detected by dual-source CT dualenergy virtual scan+enhanced scan,and the detection rate if lymph node metastasis was 86.67%(13/15).The diagnostic efficiency of dual-source CT dual-energy virtual non-contrast+enhanced scan in diagnosing benign and malignant colorectal ca ncer showed that the sensitivity,specificity,accuracy rate,positive predictive value,and negative predictive value were 94.44%,91.67%,93.33%,94.44%,and 91.67%.Conclusion Dual-source CT dual-energy virtual non-contrast has a lower radiation dose than conventional plain scan in diagnosing benign and malignant colorectal tumors.And it can ensure image quality and has higher diagnostic efficiency and higher clinical application value.
作者
路凯
兰国宾
戴士林
LU Kai;LAN Guo-bin;DAI Shi-lin(Image Center,Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou 061000,Hebei Province,China)
出处
《中国CT和MRI杂志》
2021年第9期131-134,共4页
Chinese Journal of CT and MRI
关键词
双源CT
双能量虚拟平扫
结直肠肿瘤
良恶性
鉴别诊断
Dual-source CT
Dual-energy Virtual Non-contrast
Colorectal Tumors
Benign and Malignant
Differential Diagnosis
