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乳腺癌颈胸腹盆增强CT:能谱与常规扫描模式比较

王宏 李玲 逯瑶 于克祯 王国选 姜蕾 李飒英

王宏, 李玲, 逯瑶, 等. 乳腺癌颈胸腹盆增强CT:能谱与常规扫描模式比较[J]. CT理论与应用研究, 2022, 31(4): 489-498. DOI: 10.15953/j.ctta.2022.094
引用本文: 王宏, 李玲, 逯瑶, 等. 乳腺癌颈胸腹盆增强CT:能谱与常规扫描模式比较[J]. CT理论与应用研究, 2022, 31(4): 489-498. DOI: 10.15953/j.ctta.2022.094
WANG H, LI L, LU Y, et al. Neck-chest-abdomen-pelvis combined enhanced CT in breast cancer patients: Comparison between dual-energy and conventional scanning mode[J]. CT Theory and Applications, 2022, 31(4): 489-498. DOI: 10.15953/j.ctta.2022.094. (in Chinese)
Citation: WANG H, LI L, LU Y, et al. Neck-chest-abdomen-pelvis combined enhanced CT in breast cancer patients: Comparison between dual-energy and conventional scanning mode[J]. CT Theory and Applications, 2022, 31(4): 489-498. DOI: 10.15953/j.ctta.2022.094. (in Chinese)

乳腺癌颈胸腹盆增强CT:能谱与常规扫描模式比较

doi: 10.15953/j.ctta.2022.094
详细信息
    作者简介:

    王宏:女,北京医院放射科主管技师,主要从事CT扫描技术,E-mail:redcat15@163.com

    姜蕾:女,北京医院放射科主任医师,主要从事乳腺及腹部影像诊断,E-mail:jiang_belinder@sina.com

    李飒英:女,北京医院放射科主任医师,主要从事医学影像诊断,E-mail:lisaying2000@163.com

    通讯作者:

    姜蕾*,女,北京医院放射科主任医师,主要从事乳腺及腹部影像诊断,E-mail:jiang_belinder@sina.com

    李飒英*,女,北京医院放射科主任医师,主要从事医学影像诊断,E-mail:lisaying2000@163.com

  • 中图分类号: R  816;R  322.2+7

Neck-chest-abdomen-pelvis Combined Enhanced CT in Breast Cancer Patients: Comparison between Dual-energy and Conventional Scanning Mode

  • 摘要: 目的:通过与常规扫描方案比较,探讨能谱扫描方案在乳腺癌患者颈胸腹盆联合增强CT中的应用价值。方法:回顾性分析我院因乳腺癌行颈胸腹盆联合增强CT的女性患者40例,其中行常规颈胸腹盆增强CT患者20例,能谱颈胸腹盆增强CT患者20例。比较两种扫描方案动脉期和延迟期辐射剂量;通过测量颈胸部淋巴结的信号噪声比(SNR)及对比噪声比(CNR)以及主观评分,评价两种扫描方案的图像质量。结果:常规和能谱颈胸腹盆联合增强CT扫描方案的动脉期和延迟时期的辐射剂量具有统计学差异,能谱的辐射剂量更低;颈部动脉期淋巴结的SNR值、CNR值在常规和能谱扫描之间不存在统计学差异;胸部动脉期腋窝淋巴结的SNR值、CNR值在常规和能谱扫描之间存在统计学差异;颈部淋巴结常规和能谱扫描的主观评分不存在统计学差异,胸部腋窝淋巴结常规和能谱扫描的主观评分存在统计学差异,能谱主观评分更高,主观评分一致性较好,Kappa值为0.916。结论:能谱颈胸腹盆联合增强CT扫描方案的辐射剂量更低,扫描流程更简便,患者配合度更高,对于胸部腋窝淋巴结的显示更清晰,加之能谱扫描可以提供多参数的图像数据,因此具有重要的应用推广价值。

     

  • 图  1  常规和能谱颈胸腹盆联合增强CT颈部和胸部淋巴结图像

    (a)常规颈胸腹盆联合增强CT颈部淋巴结图像;(b)能谱颈胸腹盆联合增强CT颈部淋巴结图像;(c)常规颈胸腹盆联合增强CT胸部淋巴结图像,静脉中对比剂对淋巴结的显示产生影响;(d)能谱颈胸腹盆联合增强CT胸部淋巴结图像,基本去除静脉中对比剂对周围软组织的影响,腋窝淋巴结可以清晰显示。

    Figure  1.  Cervical and axillary lymph nodes images of conventional and dual-energy scanning process of neck-chest-abdomen-pelvis combined enhanced CT

    表  1  常规颈胸腹盆增强CT扫描流程

    Table  1.   Conventional scanning process of neck-chest-abdomen-pelvis combined enhanced CT  

    项目扫描启时间/s患者姿势扫描范围
    胸腹盆动脉期25~30上举双手在头颅两侧肺尖至耻骨联合
    颈部动脉期  40放手在身体两侧  胸锁关节至乳突
    胸腹盆静脉期 60上举双手在头颅两侧肺尖至耻骨联合
    腹盆延时期 180上举双手在头颅两侧肝顶至耻骨联合
    下载: 导出CSV

    表  2  能谱颈胸腹盆增强CT扫描流程

    Table  2.   Dual-energy scanning process of neck-chest-abdomen-pelvis combined enhanced CT    

    项目扫描启动时间/s患者姿势扫描范围
    颈胸腹盆动脉期25~30上举双手在头颅两侧乳突至耻骨联合
    颈胸腹盆静脉期 60上举双手在头颅两侧乳突至耻骨联合
    腹盆延时期  180上举双手在头颅两侧肝顶至耻骨联合
    下载: 导出CSV

    表  3  常规和能谱颈胸腹盆联合增强CT扫描方案动脉期和延时期辐射剂量统计表

    Table  3.   Statistical table of radiation dose in arterial phase and extended phase of conventional and dual-energy scanning process of neck-chest-abdomen-pelvis combined enhanced CT

    项目指标辐射剂量统计检验
    常规能谱统计值P
    动脉期DLP804.84±67.12 676.62±87.02 -5.218<0.001
    CTDvol9.40±0.608.33±0.79-4.851<0.001
    ED12.07±1.01 10.15±1.31 -5.218<0.001
    延迟期DLP378.48±80.64 307.80±16.44 -3.841 0.001
    CTDvol8.14±1.376.25±0.26-6.038<0.001
    ED5.68±1.214.62±0.25-3.841 0.001
    下载: 导出CSV

    表  4  常规和能谱颈胸腹盆联合增强CT扫描方案动脉期颈部和胸部淋巴结客观图像质量评价表      

    Table  4.   Evaluation table of objective image quality of cervical and thoracic lymph nodes in arterial phase in conventional and dual-energy scanning process of neck-chest-abdomen-pelvis combined enhanced CT

    指标项目客观图像质量统计检验
    常规能谱统计值P
    CT值颈部淋巴结  52.47±13.0345.29±9.58 -1.9850.055
    颈部同层面脂肪-101.58±4.96 -100.27±5.26 -0.8130.421
    胸部淋巴结  36.92±16.0939.35±15.94 0.4800.634
    胸部同层面脂肪-106.72±8.46 -103.84±5.36 1.2880.206
    SD颈部淋巴结  10.58±2.46 9.65±2.40-1.2060.235
    颈部同层面脂肪6.83±2.226.55±1.51-0.4630.647
    胸部淋巴结  36.92±16.0939.35±15.94-4.8710.001
    胸部同层面脂肪9.15±1.796.96±1.06-4.722<0.001
    SNR颈部淋巴结  5.26±1.995.12±2.12-0.2170.830
    胸部淋巴结  2.88±1.484.32±1.84 2.7260.010
    CNR颈部淋巴结  25.02±8.57 23.20±4.96 -0.8250.416
    胸部淋巴结  16.27±3.84 20.99±3.63 3.996<0.001
    下载: 导出CSV

    表  5  常规和能谱颈胸腹盆联合增强CT扫描方案主观图像质量评分表

    Table  5.   Subjective image quality evaluation table of conventional and dual-energy scanning process of neck-chest-abdomen-pelvis combined enhanced CT

    项目主观评分者主观图像质量统计检验
    3分4分5分ZP
    颈部观察者161321-0.7630.495
    观察者271221-0.5960.602
    胸部观察者1922 9-3.7240.001
    观察者282210-3.756<0.001
    下载: 导出CSV
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  • 收稿日期:  2022-05-24
  • 修回日期:  2022-07-01
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  • 网络出版日期:  2022-07-08
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