仅使用非增强双能量光谱CT扫描对非结石性肾盂旁囊肿与肾积水进行鉴别诊断的初步研究
Preliminary study on the differentiation between parapelvic cyst and hydronephrosis with non-calculous using only pre-contrast dual-energy spectral CT scans.
作者信息
Han Dong, Ma Guangming, Wei Lequn, Ren Chenglong, Zhou Jieli, Shen Chen, He Taiping
机构信息
1 College of Medical Technology, Shaanxi University of Traditional Chinese Medicine, Xianyang, Shaanxi, China.
2 Department of Radiology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, Shaanxi, China.
出版信息
Br J Radiol. 2017 May;90(1073):20160632. doi: 10.1259/bjr.20160632. Epub 2017 Mar 10.
OBJECTIVE
To investigate the value of using the quantitative parameters from only the pre-contrast dual-energy spectral CT imaging for distinguishing between parapelvic cyst and hydronephrosis with non-calculous (HNC).
METHODS
This retrospective study was approved by the institutional review board. 28 patients with parapelvic cyst and 24 patients with HNC who underwent standard pre-contrast and multiphase contrast-enhanced dual-energy spectral CT imaging were retrospectively identified. The parapelvic cyst and HNC were identified using the contrast-enhanced scans, and their CT number in the 70-keV monochromatic images, effective atomic number (Z), iodine concentration (IC) and water concentration in the pre-contrast images were measured. The slope of the spectral curve (λ) was calculated. The difference in the measurements between parapelvic cyst and HNC was statistically analyzed using SPSS v. 19.0 (IBM Corp., New York, NY; formerly SPSS Inc., Chicago, IL) statistical software. Receiver-operating characteristic analysis was performed to assess the diagnostic performance.
RESULTS
The CT numbers in the 70-keV images, Z and IC values were statistically different between parapelvic cyst and HNC (all p < 0.05). The sensitivity, specificity and accuracy of these parameters for distinguishing between parapelvic cyst and HNC were 89.2%, 73.3% and 82.1%; 86.5%, 43.3% and 67.2%; 91.9%, 40.0% and 68.7%; and 64.9%, 73.3% and 83.6%, respectively, and the combined specificity was 92.9%. There was no statistical difference in λ between the two groups (p > 0.05).
CONCLUSION
The quantitative parameters obtained in the pre-contrast dual-energy spectral CT imaging may be used to differentiate between parapelvic cyst and HNC. Advances in knowledge: The pre-contrast dual-energy spectral CT scans may be used to screen parapelvic cysts for patients who are asymptomatic, thereby avoiding contrast-enhanced CT or CT urography examination for these patients to reduce ionizing radiation dose and contrast dose.
目的
探讨仅利用非增强双能量谱CT成像的定量参数鉴别肾盂旁囊肿与非结石性肾积水（HNC）的价值。
方法
本回顾性研究经机构审查委员会批准。回顾性纳入28例肾盂旁囊肿患者和24例HNC患者，这些患者均接受了标准的非增强及多期增强双能量谱CT成像检查。通过增强扫描识别肾盂旁囊肿和HNC，并测量其在70 keV单色图像中的CT值、有效原子序数（Z）、碘浓度（IC）以及非增强图像中的水浓度。计算光谱曲线的斜率（λ）。使用SPSS v. 19.0（IBM公司，纽约州纽约市；原SPSS公司，伊利诺伊州芝加哥市）统计软件对肾盂旁囊肿和HNC测量值的差异进行统计学分析。进行受试者操作特征分析以评估诊断性能。
结果
肾盂旁囊肿和HNC在70 keV图像中的CT值、Z值和IC值存在统计学差异（均p < 0.05）。这些参数鉴别肾盂旁囊肿和HNC的敏感性、特异性和准确性分别为89.2%、73.3%和82.1%；86.5%、43.3%和67.2%；91.9%、40.0%和68.7%；以及64.9%、73.3%和83.6%，联合特异性为92.9%。两组之间的λ无统计学差异（p > 0.05）。
结论
非增强双能量谱CT成像获得的定量参数可用于鉴别肾盂旁囊肿和HNC。知识进展：非增强双能量谱CT扫描可用于对无症状患者筛查肾盂旁囊肿，从而避免这些患者进行增强CT或CT尿路造影检查，以减少电离辐射剂量和造影剂剂量。
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