摘要
目的探讨CT分次团注双期增强对肾透明细胞癌(ccRCC)术前分期的评估价值,并分析其对辐射剂量的影响。方法于2021年6月—2024年7月期间,初步选择长沙市第四医院收治的疑似肾脏占位病变患者118例,依照随机数字表法分成单次团注组(单次团注三期增强方案)、分次团注组(分次团注双期增强方案)各59例,根据术后病理结果,最终选取100例ccRCC患者为研究对象,其中单次团注组48例,分次团注组52例。比较2组患者ccRCC组织CT增强扫描的各期CT值,以术后病理分期为金标准,分析2组方案CT增强扫描评估ccRCC术前分期的准确率,比较2组有效辐射剂量(ED)。结果2组肿瘤分期比较无差异(P>0.05)。分次团注组实质-排泄期CT值为(88.24±18.34)HU,低于单次团注组实质期CT值(102.43±20.66)HU(P<0.05)。分次团注组评估ccRCC术前分期的准确率为86.54%,与单次团注组的87.50%相较,差异无统计学意义(P>0.05)。分次团注组平均ED为(14.54±1.42)mSv,低于单次团注组的(20.43±1.18)mSv(P<0.05),与单次团注组相比,分次团注组ED下降了28.83%。结论CT分次团注双期增强与单次团注方案在评估ccRCC术前分期方面效果接近,且可减少辐射剂量。
Objective To investigate the value of split-bolus dual-phase contrast-enhanced computed tomography(CT)in preoperative staging of clear cell renal cell carcinoma(ccRCC),and to analyze its effect on radiation dose.Methods From June 2021 to July 2024,118 patients with suspected renal space occupying lesions admitted to Changsha Fourth Hospital were initially selected.Using a random number table,these patients were assigned to a single-bolus group(single-bolus three-phase enhancement program)and a split-bolus group(split-bolus dual-phase enhancement program),with 59 patients in each group.According to the postoperative pathological results,100 patients with ccRCC were selected as the study subjects,including 48 patients in the single-bolus group and 52 patients in the split-bolus group.The CT values of ccRCC tissues in various phases were compared between the two groups.The accuracy of preoperative ccRCC staging was analyzed using postoperative pathological staging as the gold standard,and the effective dose(ED)was compared between the two groups.Results There was no significant difference in ccRCC staging between the two groups(P>0.05).The CT value in the parenchyma-excretion phase of the split-bolus group was(88.24±18.34)HU,which was lower than that of the singlebolus group in the parenchyma phase[(102.43±20.66)HU,P<0.05].The accuracy of preoperative staging of ccRCC was 86.54%in the split-bolus group,which was not significantly different from 87.50%in the single-bolus group(P>0.05).The mean ED was(14.54±1.42)mSv in the split-bolus group,which was lower than(20.43±1.18)mSv in the singlebolus group(P<0.05).Compared with the single-bolus group,the ED of the split-bolus group decreased by 28.83%.Conclusion Split-bolus dual-phase contrast-enhanced CT provides similar accuracy compared to single-bolus CT in evaluating the preoperative staging of ccRCC,and can reduce the radiation dose.
作者
尹攀
张振怡
陈璨
郑兴友
YIN Pan;ZHANG Zhenyi;CHEN Can;ZHENG Xingyou(Changsha Fourth Hospital(Changsha Hospital of Integrated Traditional Chinese and Western Medicine),Changsha 410200,China)
出处
《中国辐射卫生》
2025年第4期566-570,共5页
Chinese Journal of Radiological Health
基金
湖南省卫生计生委科研计划课题一般指导项目(202209012923)。
关键词
肾透明细胞癌
分次团注
术前分期
有效辐射剂量
Clear cell renal cell carcinoma
Split-bolus
Preoperative staging
Effective dose
