【摘要】 目的:探讨能谱CT定量分析在鉴别肝脏局灶性结节增生(FNH)与肝细胞癌(HCC)中的价值。方法:回顾性分析2013年2月至12月期间经病理证实的肝占位患者35例,其中FNH 14例,HCC 21例,所有患者均行CT平扫及能谱模式三期动态增强扫描。测量增强三期病灶、肝组织以及腹主动脉的能谱参数,包括:55~75keV(间隔5keV)CT值和碘浓度。分别计算三期病灶与腹主动脉、病灶与肝组织各能谱参数的比值,包括:55~75keV的病灶与腹主动脉CT值之比(LARHU)、病灶与腹主动脉碘浓度比值(LARIC)、55~75keV的病灶与肝组织CT值之比(LHRHU)、病灶与肝组织碘浓度比值(LHRIC)。对FNH和HCC两组间上述指标进行两独立样本t检验和ROC曲线分析。结果:除动脉期(55~65keV)LHRHU、LHRIC值外,参数单能量CT值、碘浓度、LARHU、LARIC、LHRHU、LHRIC在三期增强FNH均明显高于HCC(P<0.05)。ROC曲线分析示:联合应用定量参数门脉期60keV-LARHU、延迟期75keV-LHRHU对两种疾病进行鉴别,能够提高诊断敏感度和特异度,分别为92.9%和100%。结论:三期增强能谱CT的单能量图像及碘浓度,在鉴别FNH和HCC中具有重要价值。更多还原

【Abstract】 Purpose:To explore the value of spectral CT imaging in differentiating between focal nodular hyperplasia(FNH) and hepatocellular carcinoma(HCC).Methods:From Feb.to Dec.2013,14 patients with pathologically confirmed FNH and 21 patients with pathologically confirmed HCC underwent three-phase CT spectral imaging.The spectral parameters of the lesions,normal hepatic tissues and the aortas,such as CT values of monochromatic imaging from 55 ke V to 75 ke V with 5 ke V increment and iodine concentration,were obtained.The quantitative values,including the lesion-to-aorta ratio of CT value(LARHU),the lesion-to-aorta ratio of iodine concentration(LARIC),the lesion-to-liver ratio of CT value(LHRHU),the lesion-to-liver ratio of iodine concentration(LHRIC),were analyzed with two-sample t test and ROC curve analysis.Results:The parameters of three-phase CT spectral imaging(CT value of monochromatic imaging,iodine concentration,LARHU,LARIC,LHRHU,and LHRIC)in patients with FNH were significantly higher than those of HCC(P<0.05),except of LHRHU(55~65keV)and LHRIC in the arterial phase.ROC analysis showed that combination of LARHU at 60keV in the portal vein phase and the LHRHU at 75keV in the delayed phase could improve the sensitivity(92.9%)and the specificity(100%)in differentiating FNH from HCC.Conclusion:Monochromatic and iodine concentration imaging of the three-phase CT spectral imaging are useful in differentiating FNH from HCC.更多还原