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高海拔地区颈动脉体瘤患者的CT能谱成像研究

周冬梅 尹桂秀

周冬梅, 尹桂秀. 高海拔地区颈动脉体瘤患者的CT能谱成像研究[J]. CT理论与应用研究, 2023, 32(1): 81-89. DOI: 10.15953/j.ctta.2022.059
引用本文: 周冬梅, 尹桂秀. 高海拔地区颈动脉体瘤患者的CT能谱成像研究[J]. CT理论与应用研究, 2023, 32(1): 81-89. DOI: 10.15953/j.ctta.2022.059
ZHOU D M, YIN G X. CT Spectral Imaging Study in Patients with Carotid Body Tumors at High Altitudes[J]. CT Theory and Applications, 2023, 32(1): 81-89. DOI: 10.15953/j.ctta.2022.059. (in Chinese)
Citation: ZHOU D M, YIN G X. CT Spectral Imaging Study in Patients with Carotid Body Tumors at High Altitudes[J]. CT Theory and Applications, 2023, 32(1): 81-89. DOI: 10.15953/j.ctta.2022.059. (in Chinese)

高海拔地区颈动脉体瘤患者的CT能谱成像研究

doi: 10.15953/j.ctta.2022.059
基金项目: 青海省省级临床重点专科建设项目(2020年青海省医疗服务与保障能力提升(青财社字[2020]1301号))
详细信息
    作者简介:

    周冬梅:女,青海大学影像医学与核医学专业研究生,主要从事CT能谱血管成像研究,E-mail:1536205457@qq.com

    尹桂秀:女,青海大学附属医院医学影像中心主任医师,主要从事腹部、神经系统、包虫病的影像研究,E-mail:yinguixiu6666@126.com

    通讯作者:

    尹桂秀*,女,青海大学附属医院医学影像中心主任医师,主要从事腹部、神经系统、包虫病的影像研究,E-mail:yinguixiu6666@126.com

  • 中图分类号: R  814.42;R  739.91

CT Spectral Imaging Study in Patients with Carotid Body Tumors at High Altitudes

  • 摘要: 目的:探讨CT能谱成像对颈动脉体瘤(CBT)的研究价值。方法:收集30例接受CT能谱检查并经手术确诊的CBT患者,通过GSI Viewer重建60 keV和40 keV单能量图像,对40 keV、60 keV单能量图像及120 kVp like三组图像的CBT供血动脉CT值、背景噪声(SD)、对比噪声比(CNR)、信噪比(SNR)及主观评分进行统计分析,分析CBT能谱参数及影像特征与手术结果的关系。结果:CBT动脉期及静脉期能谱参数与手术结果均无相关性;CBT横径、纵径、Shamblin分型与术中出血量呈强相关,供血动脉数量与术中出血量呈中度相关;横径、纵径、Shamblin分型与颅神经损伤呈中度相关,供血动脉数量与颅神经损伤呈强相关;40 keV是CBT供血动脉显示的最佳能级,CT值、SD、CNR及SNR均显著高于60 keV组及120 kVp like组,60 keV组CT值、噪声显著高于120 kVp like组,二者CNR及SNR差异无统计学意义;40 keV组主观评价分值最高,两位放射科医师主观评分一致性良好。结论:①CBT动脉期及静脉期能谱参数与GAPP评分无相关性;②CBT供血动脉数量是评估手术并发症重要参数之一,40 keV单能量图像可明显优化CBT供血动脉显示。

     

  • 图  1  女,53岁,右侧颈动脉体瘤

    (a)~(c)分别为CBT 40 keV、60 keV及120 kVp like的VR图像,黑色箭头所指为供血动脉;(d)~(f)分别为CBT 40 keV、60 keV及120 kVp like的MIP图像,红色箭头所指为供血动脉。

    Figure  1.  A right carotid body tumor of a 53-year-old female

    图  2  女,49 岁,右侧颈动脉体瘤

    Figure  2.  A right carotid body tumor of a 49-year-old female

    图  3  女,53岁,右侧颈动脉体瘤

    Figure  3.  A right carotid body tumor of a 49-year-old female

    表  1  30例患者的一般资料($\bar x \pm s $

    Table  1.   The general information of 30 patients $(\bar x \pm s )$

       变量参数数值(%)       变量参数数值(%)
      年龄/岁55.8±10.3    供血动脉数量/例1支15(50.0)
      性别/例男性3(10.0) 2支10(33.3)
    女性27(90.0) 3支及以上5(16.7)
      位置/例左侧13(43.3)    Shamblin分型/例Ⅰ型13(43.3)
    右侧12(40.0) Ⅱ型7(23.3)
    双侧5(16.7) Ⅲ型10(33.3)
      影像学特征横径/cm3.07±1.34    并发症术中出血量/mL157.3±237.5
    纵径/cm3.37±1.38 颅神经损伤18(60.0)
    下载: 导出CSV

    表  2  CBT能谱参数及影像特征与手术结果的相关性分析

    Table  2.   Correlation analysis between CBT energy spectrum parameters, image characteristics, and surgical results

    变量参数术中出血量颅神经损伤GAPP评分
    r1P1r2P2r3P3
    动脉期能谱参数碘浓度   0.1040.7910.4140.268-0.393 0.296
    能谱曲线斜率0.1040.7900.4160.266-0.341 0.369
    有效原子序数0.0520.8940.4160.266-0.366 0.332
    静脉期能谱参数碘浓度   -0.207 0.5930.2680.4560.2430.529
    能谱曲线斜率-0.311 0.4160.1510.6990.0760.847
    有效原子序数-0.156 0.6890.1920.6200.1170.765
    影像特征   横径    0.7880.0000.4760.0080.2960.112
    纵径    0.6690.0000.5500.0020.2870.124
    供血动脉数量0.5830.0010.6290.0000.2090.268
    Shamblin分型0.6720.0000.5290.0030.2760.140
     注:r1P1:术中出血量相关性分析结果;r2P2:颅神经损伤相关性分析结果;r3P3:GAPP评分相关性分析结果。
    下载: 导出CSV

    表  3  CBT术中出血量多因素线性回归分析

    Table  3.   Multivariate linear regression analysis of the intraoperative bleeding volume in CBT

    变量回归参数统计校验
    偏回归系数标准误标准回归系数tP
    常数-184.039 97.241-1.893 0.070
    横径 96.77039.7970.5382.4320.023
    纵径-91.71547.085-0.521 -1.948 0.063
    供血动脉数量 82.81655.9920.2641.4790.152
    Shamblin分型111.13967.7630.4211.6400.114
    下载: 导出CSV

    表  4  CBT颅神经损伤多因素线性回归分析

    Table  4.   Multivariate linear regression analysis of cranial nerve injury in CBT

    变量回归参数统计校验
    偏回归系数标准误标准回归系数tP
    常数-0.889 0.392-2.268 0.032
    横径-0.108 0.161-0.143 -.6760.505
    纵径0.1770.1900.2390.9310.361
    供血动脉数量0.7090.2260.5383.1400.004
    Shamblin分型0.2290.2730.2060.8380.410
    下载: 导出CSV

    表  5  供血动脉数量与影像特征及手术结果分析($\bar x \pm s $

    Table  5.   Analysis of the number of feeding arteries, imaging characteristics and surgical results $(\bar x \pm s) $

    变量1支/%2支/%3支及以上/%P
    Shamblin分型  横径/cm2.27±1.003.66±1.19a4.20±1.05b0.001
      纵径/cm2.61±1.403.81±0.81a4.16±1.23b0.019
      Ⅰ型10(33.33)3(10.00)0
    0.005
      Ⅱ型 3(10.00)3(10.00)1(3.33)
      Ⅲ 型2(6.67)4(13.33)4(13.33)
      术中出血量/mL56.00±35.01178.00±121.36a420.00±495.72b0.001
      颅神经损伤/支 6(20.69)12(41.38)a 11(37.93)b 0.000
      GAPP评分4.27±1.105.10±0.57a4.20±0.840.073
     注:供血动脉数量1支与2支相比,a:P<0.05;1支与3支及以上相比,b:P<0.05。
    下载: 导出CSV

    表  6  各组图像CT值、噪声、SNR及CNR比较($\bar x \pm s $

    Table  6.   Comparison of the CT values, noise, SNR and CNR of each group $(\bar x \pm s )$

    项目组别统计检验
    40 keV组60 keV组120 kVp like组FP
    CT供血动脉/HU679.17±216.65337.28±96.82c228.54±60.82d129.64 0.000
    SD脂肪/HU23.11±4.83 13.10±2.73c 9.78±2.17d143.0910.000
    CNR27.71±12.0222.28±8.65c18.84±7.82d 9.7680.001
    SNR30.62±12.3726.64±9.13c24.39±8.60d 4.8580.010
     注:40 keV组与60 keV组比较,c:P<0.05;40 keV组与120 kVp like组比较,d:P<0.05。
    下载: 导出CSV

    表  7  颈动脉体瘤供血动脉主观评分($\bar x \pm s $

    Table  7.   Subjective scores of the feeding artery of the carotid body tumor $(\bar x \pm s) $

    评分者组别统计检验
    40 keV组60 keV组120 kVp like组HP
    医师A4.85±0.723.68±0.682.55±0.3658.3050.000
    医师B4.80±0.713.53±0.662.41±0.4154.7650.000
    下载: 导出CSV
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  • 收稿日期:  2022-04-11
  • 修回日期:  2022-07-03
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  • 网络出版日期:  2022-07-18

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