| 米利晓,孙建男,赵恒宇,赵春,蒋延彬,王坤鹏,陈秀梅,王莉娜.双源CT双能量成像在体分析胆囊结石成分研究[J].中国医学影像技术,2019,35(1):143~147 |
| 双源CT双能量成像在体分析胆囊结石成分研究 |
| Dual source CT dual-energy imaging in analysis study of gallstone composition in vivo |
| 投稿时间：2018-04-21 修订日期：2018-09-23 |
| DOI：10.13929/j.1003-3289.201804112 |
| 中文关键词: 胆囊结石 成分分析 体层摄影术,X线计算机 双能量成像 |
| 英文关键词:gallstones composition analysis tomography, X-ray computed dual-energy imaging |
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| 摘要点击次数: 2439 |
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| 中文摘要: |
| 目的 探讨双源CT（DSCT）双能量成像分析体内胆囊结石成分的应用价值。方法 对200例胆囊结石患者于胆囊切除术前行DSCT双能量扫描，分析80 kV、140 kV图像对胆囊阴性结石的检出率。以显微红外光谱分析结果为判断结石成分的金标准，比较不同成分结石间80 kV图像CT值、140 kV图像CT值、CT值差值及CT值比值的差异；以ROC曲线评价不同指标鉴别胆固醇与非胆固醇成分胆囊结石的效能。结果 80 kV图像、140 kV图像及联合应用80 kV和140 kV图像对胆囊阴性结石的检出率分别为88.89%（80/90）、76.67%（69/90）和100%（90/90）。胆固醇成分结石的80 kV 图像CT值、140 kV图像 CT值、CT值差值、CT值比值均低于胆红素钙及罕见成分结石（P均<0.05），胆红素钙与罕见成分结石间差异均无统计学意义（P均>0.05）。以80 kV图像 CT值62 HU和CT值差值-2 HU为临界值，诊断胆固醇与非胆固醇成分胆囊结石的敏感度和特异度均为100%。结论 DSCT双能量成像可准确鉴别胆固醇结石与非胆固醇成分胆囊结石。 |
| 英文摘要: |
| Objective To explore the clinical value of dual-source CT (DSCT) dual-energy imaging for in vivo diagnosis of gallstone composition. Methods Totally 200 patients with gallstone undergoing cholecystectomy were collected. DSCT dual energy examination was performed preoperatively to analyze the detection rate of 80 kV and 140 kV images for gallbladder negative stones. Taken the results of micro-infrared spectroscopy as golden standards, the 80 kV images CT value, 140 kV images CT value, CT value difference and CT value ratio among different stone composition were compared. The diagnostic efficacy of each indicator in differentiating cholesterol from non-cholesterol gallstone was calculated using ROC curves. Results The detection rate of 80 kV images, 140 kV images and the combined application of both for gallbladder negative stones was 88.89% (80/90), 76.67% (69/90) and 100% (90/90), respectively. The 80 kV images CT value, 140 kV images CT value, CT value difference and CT value ratio of cholesterol composition were all lower than those of bilirubin calcium and rare composition (all P<0.05), while the difference between bilirubin calcium and rare composition was not statistically significant (all P>0.05). Taken 62 HU and -2 HU as the threshold of 80 kV images CT value and CT value difference, the sensitivity and specificity in diagnosis of cholesterol and non-cholesterol composition stones were both 100%. Conclusion DSCT dual-energy imaging can be used in accurate identification of gallbladder cholesterol gallstones and non-cholesterol gallstones. |
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