Objective:To investigate the diagnostic value of spectral CT reconstruction mode for carotid atherosclerotic plaque lesions.Methods:From January 2017 to January 2019,70 patients with carotid atherosclerotic plaque les...Objective:To investigate the diagnostic value of spectral CT reconstruction mode for carotid atherosclerotic plaque lesions.Methods:From January 2017 to January 2019,70 patients with carotid atherosclerotic plaque lesions in our hospita1 were selected as the research object.A11 patients were diagnosed with cervical vascular color Doppler ultrasound and spectral CT scan under spectral cr reconstruction mode.Taking the results of coronaryf angiography as the"gold standard",the clinical value of the two examination methods in the diagnosis of carotid atherosclerotic plaque lesions was compared and analyzed.Results:Coronary angiography diagnosis confirmed that 33 of 70 patients with suspected carotid atherosclerotic plaque lesions had vulnerable plaques and 37 had stable plaques.The accuracy of Spectral CT examination of carotid artery plaque was 87.14%(61/70),sensitivity was 90.91%(30/33),specificity was 83.78%(31/37),and the positive predictive value was 83.33%(30/36),the negative predictive value is 91.76%(31/34),which is higher than that of cervical vascular ultrasonography(61.43%,60.61%,56.76%,57.89%,65.63%),the difference is statistically significant(P<0.05).Conclusion:The application of Spectral CT in the clinical diagnosis and treatment of carotid atherosclerotic plaque lesions with higher accuracy,sensitivity and specificity,is more significant and can provide a more reliable and effective imaging basis.展开更多
Objective: To explore the correlation between the spectral computed tomography(CT) imaging parameters and the Ki-67 labeling index in lung adenocarcinoma.Methods: Spectral CT imaging parameters [iodine concentrations ...Objective: To explore the correlation between the spectral computed tomography(CT) imaging parameters and the Ki-67 labeling index in lung adenocarcinoma.Methods: Spectral CT imaging parameters [iodine concentrations of lesions(ICLs) in the arterial phase(ICLa)and venous phase(ICLv), normalized IC in the aorta(NICa/NICv), slope of the spectral HU curve(λHUa/λHUv)and monochromatic CT number enhancement on 40 keV and 70 keV images(CT40 keVa/v, CT70keVa/v)] in 34 lung adenocarcinomas were analyzed, and common molecular markers, including the Ki-67 labeling index, were detected with immunohistochemistry. Different Ki-67 labeling indexes were measured and grouped into four grades according to the number of positive-stained cells(grade 0, ≤1%;1%<grade 1≤10%;10%<grade 2≤30%;and grade 3, >30%). One-way analysis of variance(ANOVA) was used to compare the four different grades, and the Bonferroni method was used to correct the P value for multiple comparisons. A Spearman correlation analysis was performed to further research a quantitative correlation between the Ki-67 labeling index and spectral CT imaging parameters.Results: CT40keVa, CT40 keVv, CT70keVa and CT70keVv increased as the grade increased, and CT70keVa and CT70keVv were statistically significant(P<0.05). These four parameters and the Ki-67 labeling index showed a moderate positive correlation with lung adenocarcinoma nodules. ICL, NIC and λHU in the arterial and venous phases were not significantly different among the four grades.Conclusions: The spectral CT imaging parameters CT40keVa, CT40keVv, CT70keVa and CT70keVv gradually increased with Ki-67 expression and showed a moderate positive correlation with lung adenocarcinomas.Therefore, spectral CT imaging parameter-enhanced monochromatic CT numbers at 70 keV may indicate the extent of proliferation of lung adenocarcinomas.展开更多
Objective： This study investigated the capability of dual-energy spectral computed tomography （CT） to quantitatively evaluate lung perfusion defects that are induced by central lung cancer. Methods： Thirty-two pat...Objective： This study investigated the capability of dual-energy spectral computed tomography （CT） to quantitatively evaluate lung perfusion defects that are induced by central lung cancer. Methods： Thirty-two patients with central lung cancer underwent CT angiography using spectral imaging. A univariate general linear model was conducted to analyze the variance of iodine concentration/CT value with three factors of lung fields. A paired t-test was used to compare iodine concentrations and CT values between the distal end of lung cancer and the corresponding area in the contralateral normal lung. Results： Iodine concentrations increased progressively in the far, intermediate and near ground sides in the normal lung fields at 0.60±0.28, 0.93±0.27 and 1.25±0.38 mg/mL, respectively （P〈0.001）. The same trend was observed for the CT values [-（840.64±49.08）, -（812.66±50.85） and -（760.83±89.17） HU, P〈0.001]. The iodine concentration （0.70±0.42 mg/mL） of the lung field in the distal end of lung cancer was significantly lower than the corresponding area in the contralateral normal lung （1.19±0.62 mg/mL） （t=-7.23, P〈0.001）. However, the CT value of lung field in the distal end of lung cancer was significantly higher than the corresponding area in the contralateral normal lung [-（765.29±93.34） HU vs. -（800.07±76.18） HU, t=3.564, P=0.001]. Conclusions： Spectral CT imaging based on the spectral differentiation of iodine is feasible and can quantitatively evaluate pulmonary perfusion and identify perfusion defects that are induced by central lung cancer. Spectral CT seems to be a promising technique for the simultaneous evaluation of both morphological and functional lung information.展开更多
目的:研究基于光子计数探测器CT(photon-counting detector CT,PCD-CT)采集的能谱定位像(spectral localizer radiograph,SLR)定量检测股骨颈的面积骨密度(areal bone mineral density,aBMD)的效能。方法:于2024年7月至2025年4月前瞻性...目的:研究基于光子计数探测器CT(photon-counting detector CT,PCD-CT)采集的能谱定位像(spectral localizer radiograph,SLR)定量检测股骨颈的面积骨密度(areal bone mineral density,aBMD)的效能。方法:于2024年7月至2025年4月前瞻性纳入需接受双能量X射线吸收法(dual-energy X-ray absorptiometry,DXA)以及CT扫描这2种检查的受试者(≥18岁)。这些患者在PCD-CT上接受检查获取SLR,由2名观察者在SLR上独立、盲法测量患者左侧股骨颈的aBMD。以DXA的测量结果为标准,评估SLR对aBMD的定量准确性及针对异常骨量(T值<-1.0)的诊断效能。结果:本研究共纳入63名受试者(其中女性36人),平均年龄(64.30±13.20)岁,DXA测得的中位aBMD值为0.889[四分位间距(interquartile range,IQR)为0.749~1.031]g/cm^(2),其中23人(36.51%)表现出异常骨量。2名观察者测量的aBMD值[中位数(IQR)表示]分别为0.879(0.760~0.985)g/cm^(2)和0.891(0.784~0.977)g/cm^(2),基于SLR测量的aBMD值具有极好的观察者间一致性(组内相关系数为0.98)。以DXA结果为参考,SLR测量aBMD的中位百分比绝对误差为6.66%(IQR为3.64%~9.80%),基于SLR诊断异常骨量的准确率、灵敏度、特异度分别为95.24%(50/63)、95.65%(22/23)、95.00%(38/40)。结论:基于PCD-CT采集的能谱定位像可以准确定量股骨颈的骨密度,并表现出较高的异常骨量诊断效能。展开更多
目的采用循证医学Meta分析的方法,评估使用能谱CT碘浓度值(IC)和标准化碘浓度值(nIC)定量参数鉴别胃癌淋巴结转移的效能。方法全面检索PubMed、EMBASE、Cochrane Library、Web of Science、中国知网、万方数据库六大数据库于2010年1月至...目的采用循证医学Meta分析的方法,评估使用能谱CT碘浓度值(IC)和标准化碘浓度值(nIC)定量参数鉴别胃癌淋巴结转移的效能。方法全面检索PubMed、EMBASE、Cochrane Library、Web of Science、中国知网、万方数据库六大数据库于2010年1月至2025年1月期间发表的有关能谱CT诊断胃癌淋巴结转移的相关文献,对符合纳入条件的文献进行质量评估、提取特征数据,并评价异质性。根据研究对象不同,文献可分为淋巴结相关能谱CT参数来预测淋巴结转移以及胃肿瘤相关能谱CT参数来预测淋巴结转移两大类。对淋巴结中研究较多的参数:动脉期标准化碘浓度值(nICa)和胃肿瘤中研究较多的参数:静脉期碘浓度值和标准化碘浓度值(ICp和nICp)进行效应量合并,得到合并后的敏感度、特异性、阳性似然比和诊断比值比。绘制森林图和综合受试者工作特征(SROC)曲线,并计算曲线下面积(AUC)。绘制Begg's漏斗图进行不对称性检验检验是否有发表偏倚。结果符合纳入标准且进入Meta分析的文献共10篇,并根据数据类型分为淋巴结数据3例,胃肿瘤数据7例。淋巴结nICa存在发表偏倚,肿瘤ICp和nICp不存在发表偏倚。3个参数的合并AUC分别为0.85(95%CI:0.81~0.87])、0.79(95%CI:0.76~0.83)、0.83(95%CI:0.80~0.86)。结论能谱CT凭借其无创、便捷、经济高效的优势应用于胃癌淋巴结转移的评估中,其中碘浓度值相关参数有一定的应用价值,为术前评估胃癌淋巴结转移提供了新的思路。展开更多
文摘Objective:To investigate the diagnostic value of spectral CT reconstruction mode for carotid atherosclerotic plaque lesions.Methods:From January 2017 to January 2019,70 patients with carotid atherosclerotic plaque lesions in our hospita1 were selected as the research object.A11 patients were diagnosed with cervical vascular color Doppler ultrasound and spectral CT scan under spectral cr reconstruction mode.Taking the results of coronaryf angiography as the"gold standard",the clinical value of the two examination methods in the diagnosis of carotid atherosclerotic plaque lesions was compared and analyzed.Results:Coronary angiography diagnosis confirmed that 33 of 70 patients with suspected carotid atherosclerotic plaque lesions had vulnerable plaques and 37 had stable plaques.The accuracy of Spectral CT examination of carotid artery plaque was 87.14%(61/70),sensitivity was 90.91%(30/33),specificity was 83.78%(31/37),and the positive predictive value was 83.33%(30/36),the negative predictive value is 91.76%(31/34),which is higher than that of cervical vascular ultrasonography(61.43%,60.61%,56.76%,57.89%,65.63%),the difference is statistically significant(P<0.05).Conclusion:The application of Spectral CT in the clinical diagnosis and treatment of carotid atherosclerotic plaque lesions with higher accuracy,sensitivity and specificity,is more significant and can provide a more reliable and effective imaging basis.
基金supported by National Natural Science Foundation of China (No. 91959116)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (No. ZYLX 201803)+1 种基金“Beijing Hospitals Authority” Ascent Plan (No. DFL20191103)National Key R&D Program of China (No. 2017YFC1309101, 2017YFC1309104).
文摘Objective: To explore the correlation between the spectral computed tomography(CT) imaging parameters and the Ki-67 labeling index in lung adenocarcinoma.Methods: Spectral CT imaging parameters [iodine concentrations of lesions(ICLs) in the arterial phase(ICLa)and venous phase(ICLv), normalized IC in the aorta(NICa/NICv), slope of the spectral HU curve(λHUa/λHUv)and monochromatic CT number enhancement on 40 keV and 70 keV images(CT40 keVa/v, CT70keVa/v)] in 34 lung adenocarcinomas were analyzed, and common molecular markers, including the Ki-67 labeling index, were detected with immunohistochemistry. Different Ki-67 labeling indexes were measured and grouped into four grades according to the number of positive-stained cells(grade 0, ≤1%;1%<grade 1≤10%;10%<grade 2≤30%;and grade 3, >30%). One-way analysis of variance(ANOVA) was used to compare the four different grades, and the Bonferroni method was used to correct the P value for multiple comparisons. A Spearman correlation analysis was performed to further research a quantitative correlation between the Ki-67 labeling index and spectral CT imaging parameters.Results: CT40keVa, CT40 keVv, CT70keVa and CT70keVv increased as the grade increased, and CT70keVa and CT70keVv were statistically significant(P<0.05). These four parameters and the Ki-67 labeling index showed a moderate positive correlation with lung adenocarcinoma nodules. ICL, NIC and λHU in the arterial and venous phases were not significantly different among the four grades.Conclusions: The spectral CT imaging parameters CT40keVa, CT40keVv, CT70keVa and CT70keVv gradually increased with Ki-67 expression and showed a moderate positive correlation with lung adenocarcinomas.Therefore, spectral CT imaging parameter-enhanced monochromatic CT numbers at 70 keV may indicate the extent of proliferation of lung adenocarcinomas.
基金supported by National Natural Science Foundation of China(Grant No.81071129,30970825)the National Basic Research Program of China(973 Program)(Grant No.2011CB707705)
文摘Objective： This study investigated the capability of dual-energy spectral computed tomography （CT） to quantitatively evaluate lung perfusion defects that are induced by central lung cancer. Methods： Thirty-two patients with central lung cancer underwent CT angiography using spectral imaging. A univariate general linear model was conducted to analyze the variance of iodine concentration/CT value with three factors of lung fields. A paired t-test was used to compare iodine concentrations and CT values between the distal end of lung cancer and the corresponding area in the contralateral normal lung. Results： Iodine concentrations increased progressively in the far, intermediate and near ground sides in the normal lung fields at 0.60±0.28, 0.93±0.27 and 1.25±0.38 mg/mL, respectively （P〈0.001）. The same trend was observed for the CT values [-（840.64±49.08）, -（812.66±50.85） and -（760.83±89.17） HU, P〈0.001]. The iodine concentration （0.70±0.42 mg/mL） of the lung field in the distal end of lung cancer was significantly lower than the corresponding area in the contralateral normal lung （1.19±0.62 mg/mL） （t=-7.23, P〈0.001）. However, the CT value of lung field in the distal end of lung cancer was significantly higher than the corresponding area in the contralateral normal lung [-（765.29±93.34） HU vs. -（800.07±76.18） HU, t=3.564, P=0.001]. Conclusions： Spectral CT imaging based on the spectral differentiation of iodine is feasible and can quantitatively evaluate pulmonary perfusion and identify perfusion defects that are induced by central lung cancer. Spectral CT seems to be a promising technique for the simultaneous evaluation of both morphological and functional lung information.
基金江苏省卫生与健康委员会重点科研项目(编号:K2023027)苏州大学“医学+X”科研项目(编号:grant number ML12203423)+2 种基金江苏省研究型医院学会感染与炎症放射学专委会科研基金资助项目(编号:GY202301)江苏省科教能力提升工程(江苏省医学重点学科建设)项目(编号:JSDW202242)苏州市影像医学重点实验室(编号:SZS2024032)。
文摘目的采用循证医学Meta分析的方法,评估使用能谱CT碘浓度值(IC)和标准化碘浓度值(nIC)定量参数鉴别胃癌淋巴结转移的效能。方法全面检索PubMed、EMBASE、Cochrane Library、Web of Science、中国知网、万方数据库六大数据库于2010年1月至2025年1月期间发表的有关能谱CT诊断胃癌淋巴结转移的相关文献,对符合纳入条件的文献进行质量评估、提取特征数据,并评价异质性。根据研究对象不同,文献可分为淋巴结相关能谱CT参数来预测淋巴结转移以及胃肿瘤相关能谱CT参数来预测淋巴结转移两大类。对淋巴结中研究较多的参数:动脉期标准化碘浓度值(nICa)和胃肿瘤中研究较多的参数:静脉期碘浓度值和标准化碘浓度值(ICp和nICp)进行效应量合并,得到合并后的敏感度、特异性、阳性似然比和诊断比值比。绘制森林图和综合受试者工作特征(SROC)曲线,并计算曲线下面积(AUC)。绘制Begg's漏斗图进行不对称性检验检验是否有发表偏倚。结果符合纳入标准且进入Meta分析的文献共10篇,并根据数据类型分为淋巴结数据3例,胃肿瘤数据7例。淋巴结nICa存在发表偏倚,肿瘤ICp和nICp不存在发表偏倚。3个参数的合并AUC分别为0.85(95%CI:0.81~0.87])、0.79(95%CI:0.76~0.83)、0.83(95%CI:0.80~0.86)。结论能谱CT凭借其无创、便捷、经济高效的优势应用于胃癌淋巴结转移的评估中,其中碘浓度值相关参数有一定的应用价值,为术前评估胃癌淋巴结转移提供了新的思路。
