宝石能谱CT成像技术在显示肝硬化门静脉高压侧支循环中的应用研究
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摘要
目的探讨宝石能谱CT成像技术在显示肝硬化门静脉高压(PH)侧支循环中的应用价值。方法回顾性分析2015年1月至2017年6月行多层螺旋CT门静脉成像(MSCTP)检查的80例肝硬化PH患者影像学资料,其中GE light speed 64层螺旋CT扫描(传统CT组)、GE Discovery CT750 HD宝石能谱CT扫描(能谱CT组)各40例,比较2组图像质量[肝内外门静脉对比噪声比(CNR)、图像噪声(IN)],并以胃镜检查为金标准,比较2组食管胃底静脉曲张诊断结果。结果能谱CT组肝内门静脉、肝外门静脉CNR、IN均显著大于传统CT组(P<0.05);胃镜检出食管胃底静脉曲张35例;以胃镜为金标准,传统CT组诊断食管胃底静脉曲张敏感度、特异度、准确度分别为82.86%、60.00%、80.00%,能谱CT组诊断敏感度、特异度、准确度分别为94.28%、80.00%、92.50%,2组比较差异均无统计学意义(P>0.05)。结论宝石能谱CT相比传统CT门静脉成像质量显著高,两者均能有效显示肝硬化PH食管胃底静脉曲张。
Objective To investigate the application value of gemstone energy spectrum CT imaging technique in displaying the collateral circulation of cirrhotic portal hypertension(PH).Methods The imaging data of 80 patients with cirrhotic PH who underwent multi slice spiral CT portal imaging(MSCTP) in our hospital from January 2015 to June 2017 were analyzed retrospectively. Among the subjects, the 40 patients who underwent GE light speed 64 slice spiral CT scanning were divided into traditional CT group,and the other 40 patients who underwent GE Discovery CT750 HD gemstone energy spectrum CT scanning were divided into energy spectrum CT group. The image quality including intrahepatic and extrahepatic portal vein contrast noise ratios(CNR) as well as pattern noise(IN) were observed and compared between the two groups. The diagnostic results of esophageal and gastric varices were observed and compared between the two groups by taking the results of gastroscopy as the golden standard.Results The CNR and IN of intrahepatic and extrahepatic portal veins in energy spectrum CT group were significantly higher than those in traditional CT group(P<0.05). There were 35 cases of esophageal and gastric varices detected by gastroscopy. There were no significantly differences in the sensitivity, specificity and accuracy of diagnosis results between the two group(traditional CT group vs energy spectrum CT group: 82.86% vs 94.28%, 60.00% vs 80.00%, 80.00% vs 92.50%,respectively,P>0.05).Conclusion The imaging quality of gemstone energy spectrum CT is significantly better than that of traditional CT portal photography, both of them can effectively display the esophageal and gastric varices in patients with cirrhotic PH.
Objective To investigate the application value of gemstone energy spectrum CT imaging technique in displaying the collateral circulation of cirrhotic portal hypertension(PH).Methods The imaging data of 80 patients with cirrhotic PH who underwent multi slice spiral CT portal imaging(MSCTP) in our hospital from January 2015 to June 2017 were analyzed retrospectively. Among the subjects, the 40 patients who underwent GE light speed 64 slice spiral CT scanning were divided into traditional CT group,and the other 40 patients who underwent GE Discovery CT750 HD gemstone energy spectrum CT scanning were divided into energy spectrum CT group. The image quality including intrahepatic and extrahepatic portal vein contrast noise ratios(CNR) as well as pattern noise(IN) were observed and compared between the two groups. The diagnostic results of esophageal and gastric varices were observed and compared between the two groups by taking the results of gastroscopy as the golden standard.Results The CNR and IN of intrahepatic and extrahepatic portal veins in energy spectrum CT group were significantly higher than those in traditional CT group(P<0.05). There were 35 cases of esophageal and gastric varices detected by gastroscopy. There were no significantly differences in the sensitivity, specificity and accuracy of diagnosis results between the two group(traditional CT group vs energy spectrum CT group: 82.86% vs 94.28%, 60.00% vs 80.00%, 80.00% vs 92.50%,respectively,P>0.05).Conclusion The imaging quality of gemstone energy spectrum CT is significantly better than that of traditional CT portal photography, both of them can effectively display the esophageal and gastric varices in patients with cirrhotic PH.
引文
1 张嘉瑜,刘龙平,王成林,等.肝硬化门静脉高压侧支血管开放的影像学特征及临床意义.中国CT和MRI杂志,2016,14:77-80,122.
2 李大勇,郭应林,李大庆,等.64层螺旋CT门静脉造影在显示肝硬化门静脉高压侧支循环中的价值.中国医学影像学杂志,2010,18:343-347.
3 梁萍,方华盛,陈更瑞,等.多层螺旋CT门静脉成像对门静脉高压症的诊断及分类价值.中国CT和MRI杂志,2015,13:47-49,57.
4 刘欣,孟志华,黄丛云,等.肝硬化门静脉高压并侧支循环多层螺旋CT固定时间点扫描的影像表现.山西医科大学学报,2015,46:111-115.
5 王芳,沈加林,华静,等.能谱CT评估肝硬化食管静脉曲张程度的价值研究.临床放射学杂志,2016,35:208-212.
6 程明,陈文军,赵新宇,等.正常肝脏和肝硬化门静脉高压患者CT增强扫描参数研究.中国中西医结合影像学杂志,2015,13:138-140.
7 戴细华,王楚铭.CT能谱成像技术诊断肝硬化门静脉高压并发EVB的价值.浙江临床医学,2016,18:1337-1338.
8 赵丽琴,贺文,李剑颖,等.能谱CT对门静脉成像质量影响的研究.CT理论与应用研究,2011,20:383-390.
9 Minamiguchi H,Kawai N,Sato M,et al.Dual microcatheter retrograde tra-nsvenous obliteration of gastric varices:coil embolization as a substitute for b-alloon occlusion.Case Rep Gastroenterol,2012,6:74-81.
10 赵丽琴,贺文,李剑颖,等.应用能谱CT研究肝硬化门静脉高压患者肝血流动力学变化.中华放射学杂志,2011,45:782-783.
11 王辉,于长路,韩宇欣,等.CT门静脉成像对门静脉高压食管胃底静脉曲张诊断的临床意义.国际医学放射学杂志,2017,40:249-253.
12 张军,邓克学.能谱CT预测肝硬化门静脉高压患者并发食管静脉曲张破裂出血风险.中国医学影像技术,2012,28:2201-2205.
13 Rahimi RS,Rockey DC.End-stage liver disease complications.Curr Opin Gastroenterol,2013,29:257-263.
2 李大勇,郭应林,李大庆,等.64层螺旋CT门静脉造影在显示肝硬化门静脉高压侧支循环中的价值.中国医学影像学杂志,2010,18:343-347.
3 梁萍,方华盛,陈更瑞,等.多层螺旋CT门静脉成像对门静脉高压症的诊断及分类价值.中国CT和MRI杂志,2015,13:47-49,57.
4 刘欣,孟志华,黄丛云,等.肝硬化门静脉高压并侧支循环多层螺旋CT固定时间点扫描的影像表现.山西医科大学学报,2015,46:111-115.
5 王芳,沈加林,华静,等.能谱CT评估肝硬化食管静脉曲张程度的价值研究.临床放射学杂志,2016,35:208-212.
6 程明,陈文军,赵新宇,等.正常肝脏和肝硬化门静脉高压患者CT增强扫描参数研究.中国中西医结合影像学杂志,2015,13:138-140.
7 戴细华,王楚铭.CT能谱成像技术诊断肝硬化门静脉高压并发EVB的价值.浙江临床医学,2016,18:1337-1338.
8 赵丽琴,贺文,李剑颖,等.能谱CT对门静脉成像质量影响的研究.CT理论与应用研究,2011,20:383-390.
9 Minamiguchi H,Kawai N,Sato M,et al.Dual microcatheter retrograde tra-nsvenous obliteration of gastric varices:coil embolization as a substitute for b-alloon occlusion.Case Rep Gastroenterol,2012,6:74-81.
10 赵丽琴,贺文,李剑颖,等.应用能谱CT研究肝硬化门静脉高压患者肝血流动力学变化.中华放射学杂志,2011,45:782-783.
11 王辉,于长路,韩宇欣,等.CT门静脉成像对门静脉高压食管胃底静脉曲张诊断的临床意义.国际医学放射学杂志,2017,40:249-253.
12 张军,邓克学.能谱CT预测肝硬化门静脉高压患者并发食管静脉曲张破裂出血风险.中国医学影像技术,2012,28:2201-2205.
13 Rahimi RS,Rockey DC.End-stage liver disease complications.Curr Opin Gastroenterol,2013,29:257-263.