[双源双能量CT碘图在急性坏死性胰腺炎诊断中的价值]

[The value of dual-source dual-energy CT with iodine overlay in the diagnosis of acute necrotizing pancreatitis].

作者信息

Yuan Yuan, Huang Zi-Xing, Li Zhen-Lin, Song Bin, Deng Li-Ping

机构信息

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2012 Jul;43(4):597-600.

PMID:22997904

Abstract

OBJECTIVE

To investigate the clinical value of dual-source computed tomography dual-energy Iodine overlay technique in the imaging diagnosis of acute necrotizing pancreatitis.

METHODS

The imaging data were retrospectively analyzed in 67 cases of acute necrotizing pancreatitis underwent contrast-enhanced dual-source dual-energy CT in portal venous phase. The CT imaging parameters, including the difference of CT value between pancreatic parenchyma and necrotic lesion, contrast-to-noise ratio of pancreatic parenchyma-to-necrosis, area of pancreatic necrosis and score of subjective diagnosis, were measured and assessed on CT images of 80 kV, 140 kV, weighted-average 120 kV as well as Iodine overlay.

RESULTS

The differences of CT value between pancreatic parenchyma and necrosis in the images of 80 kV, 140 kV, weighted-average 120 kV and Iodine overlay were (67.40 +/- 20.82) HU, (42.87 +/- 14.99) HU, (48.69 +/- 15.82) HU, (33.01 +/- 10.26) HU, respectively; contrast-to-noise ratios of pancreatic parenchyma-to-necrosis of each group were 8.36 +/- 3.58, 5.85 +/- 2.65, 7.68 +/- 3.51, 10.60 4.34; area of pancreatic necrosis of each group was (3.78 +/- 2.68) cm2, (3.28 +/- 2.59) cm2, (3.37 +/- 2.46) cm2, (2.42 +/- 1.98) cm2; the score of subjective diagnosis of each group was 3.88 +/- 0.33, 3.31 +/- 0.80, 3.58 +/- 0.66, 2.81 +/- 0.76, respectively. The four indexes in the images of Iodine overlay were significantly different from those of another three groups (P < 0.05). Contrast-to-noise ratio of pancreatic parenchyma-to-necrosis in the images of Iodine overlay was significantly higher than that of another three groups, while the difference of CT value, area of pancreatic necrosis and score of subjective diagnosis were lower. CONCLUSION; Dual-source CT dual-energy Iodine overlay is not helpful to improve subjective judgment in the diagnosis of pancreatic necrosis, but contributes to the display of hypoperfusion area around the necrosis.

摘要

目的

探讨双源计算机断层扫描双能量碘叠加技术在急性坏死性胰腺炎影像诊断中的临床价值。

方法

回顾性分析67例急性坏死性胰腺炎患者门静脉期双源双能量CT增强扫描的影像资料。在80 kV、140 kV、加权平均120 kV以及碘叠加的CT图像上测量并评估CT成像参数，包括胰腺实质与坏死灶之间的CT值差值、胰腺实质与坏死灶的对比噪声比、胰腺坏死面积及主观诊断评分。

结果

80 kV、140 kV、加权平均120 kV及碘叠加图像上胰腺实质与坏死灶之间的CT值差值分别为(67.40±20.82)HU、(42.87±14.99)HU、(48.69±15.82)HU、(33.01±10.26)HU；各组胰腺实质与坏死灶的对比噪声比分别为8.36±3.58、5.85±2.65、7.68±3.51、10.60±4.34；各组胰腺坏死面积分别为(3.78±2.68)cm²、(3.28±2.59)cm²、(3.37±2.46)cm²、(2.42±1.98)cm²；各组主观诊断评分分别为3.88±0.33、3.31±0.80、3.58±0.66、2.81±0.76。碘叠加图像上的四项指标与其他三组相比差异有统计学意义(P<0.05)。碘叠加图像上胰腺实质与坏死灶的对比噪声比明显高于其他三组，而CT值差值、胰腺坏死面积及主观诊断评分较低。结论：双源CT双能量碘叠加对提高胰腺坏死诊断的主观判断无帮助，但有助于显示坏死灶周围的低灌注区。