胰腺连续动态增强CT术前诊断胰岛素瘤的价值
Application of Continuing Dynamic Enhanced CT Scanning in Preoperatively Diagnosing Insulinomas
魏黎明 1鲁海涛 1赵俊功1
作者信息
- 1. 200233 上海交通大学附属第六人民医院放射科
- 折叠
摘要
目的 探讨胰腺连续动态增强CT(PDCE-CT)术前诊断胰岛素瘤的价值,以提高胰岛素瘤检测敏感性,并分析常规增强CT检测胰岛素瘤的最佳图像采集时间窗.方法 回顾性分析23例经手术、病理证实的胰岛素瘤,共计17例患者行胰腺连续动态增强CT,另共计9例患者行胰腺常规增强CT(其中4例患者常规CT增强阴性者进一步行胰腺连续动态增强),比较胰腺动态增强CT与常规增强CT对胰岛素瘤术前诊断的敏感性,探究胰岛素瘤强化峰值(PH)、胰岛素瘤及周围正常胰腺组织密度差值(T-P差值)峰值以及T-P差值＞35 HU的时间段,并总结胰岛素瘤CT图像特征.结果 (1)PDCE-CT与常规增强CT敏感性分别为94.1％ (16/17)、55.6％ (5/9),两者具有统计学差异(P=0.035,P＜0.05).(2)PDCE-CT的PH值为(174.6 ±45.4) HU[时间点为(23.4±13.1)s],T-P差值PH值为(65.8±34.4) HU[时间点为(32.4±12.3)s],T-P差值＞35 HU时间段为25.3±14.4 ～51.3 ±18.9s.结论 PDCE-CT较常规增强CT对于术前诊断胰岛素瘤具有更好的敏感性;行常规增强CT时,在注入对比剂后25.3±14.4～51.3±18.9 s时间窗内采集图像对于术前诊断胰岛素瘤价值更大,但个体差异较大.
Abstract
Objective To evaluate continuous dynamic enhanced CT (CDE CT) scanning of pancreas in preoperatively diagnosing insulinomas in order to improve the diagnostic sensitivity for insulinomas,and to discuss the optimal image acquisition time-window of conventional enhanced CT scanning for the detection of insulinomas.Methods Clinical data of 23 cases with surgically and pathologically proved insulinomas were retrospective analyzed.Among the 23 patients,CDE CT scanning was carried out in 17 and conventional enhanced CT scanning in 9,in 4 of whom additional CDE CT scanning was also employed as conventional enhanced CT scanning showed normal findings.The preoperative diagnostic sensitivity for insulinomas of CDE CT was compared with that of conventional enhanced CT.The enhancement peak height value (PH value) and the tumor-normal pancreas density difference value (T-P value) were determined.The period of time that had T-P value ≥35 HU was measured.The CT imaging features were analyzed.Results (1) The diagnostic sensitivity of CDE CT and conventional enhanced CT was 94.1％ (16/17) and 55.6％ (5/9) respectively,and the difference between the two methods was statistically significant (P =0.035,P ＜ 0.05).(2) The PH value of CDE CT was (174.6 ± 45.4) HU,which appeared at the time point of (23.4 ± 13.1) s.The PH of T-P difference value was (65.8 ±34.4) HU,which appeared at the time point of (32.4 ± 12.3) s.The period of time that showed T-P value ≥35 HU varied from (25.3 ± 14.4) to (51.3 ± 18.9) s.Conclusion In preoperatively making diagnosis of insulinomas,CDE CT is more sensitive than conventional enhanced CT.The optimal image acquisition time-window of conventional enhanced CT is between (25.3 ± 14.4) to (51.3 ± 18.9) seconds after the injection of contrast,although the individual difference is very large.
关键词
连续动态增强/体层摄影术,X线计算机/胰腺/胰岛素瘤Key words
Dynamic consecutive enhanced/Tomography,X-ray computed/Pancreas/Insulinoma引用本文复制引用
出版年
2014
NETL
NSTL
维普
万方数据