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能谱CT在肝胆疾病诊断中的应用

李伯龙 彭心宇 乔飞 徐强 赵伯文

引用本文:
Citation:

能谱CT在肝胆疾病诊断中的应用

DOI: 10.3969/j.issn.1001-5256.2017.03.043
详细信息
  • 中图分类号: R575

Application of spectral computed tomography in diagnosis of liver and gallbladder diseases

  • 摘要: 能谱CT成像是宝石探头和强大的计算机后处理技术的完美结合,是对传统CT的一次技术革命。对能谱CT在肝脏、胆囊疾病中的诊断应用作一综述。总结了能谱CT的单能量图像、能谱曲线、物质分离与定量以及有效原子序数等技术在肝胆疾病诊断及鉴别方面的应用价值,并分析其在发现微小病灶、低剂量、判断同源性的优势所在。认为能谱CT在肿瘤的早期发现、鉴别及预后中有很多可探寻的方面。

     

  • [1]SHEN JY.Preliminary study on the application value of spectral CTimaging in diagnosis of differential hepatic lesions[D].Fujian:Fujian Medical University, 2011. (in Chinese) 沈君怡.CT能谱成像对肝脏占位病变鉴别诊断应用价值的初步研究[D].福建:福建医科大学, 2011.
    [2]ZHOU J, LYU YC.Application of spectral CT imaging in the diagnosis of tumor[J].Chin J Neuro-Oncology, 2011, 9 (4) :263-266. (in Chinese) 周健, 吕衍春.CT能谱成像在肿瘤诊断中的应用[J].中国神经肿瘤杂志, 2011, 9 (4) :263-266.
    [3]LU FM, LIU HY, LI YX.The value of spectral CT imaging and multi parameter in differential diagnosis of hepatocellular carcinoma and FNH[J].Chin J CT MRI, 2015, 13 (8) :64-66, 73. (in Chinese) 鲁法美, 刘红艳, 李玉新.CT能谱多参数成像在鉴别肝癌和FNH中的应用价值分析[J].中国CT和MRI杂志, 2015, 13 (8) :64-66, 73.
    [4]WANG GS, GAO JH, ZHAO S.The value of spectral CT in improving the detection rate of liver nodule[J].Chin Comput Med Imag, 2013, 19 (1) :43-46. (in Chinese) 王贵生, 高建华, 赵帅.能谱CT对提高肝占位性结节检出率的应用价值[J].中国医学计算机成像杂志, 2013, 19 (1) :43-46.
    [5]GRASER A, JOHNSON TR, CHANDARANA H, et al.Dual-energy CT:preliminary observations and potential clinical applications in the abdomen[J].Eur Radiol, 2009, 19 (1) :13-23.
    [6]SHEN HJ, ZENG XZ, LIU YJ, et al.The value of spectral CT single energy imaging in liver image quality and diagnosis[J].Chin Comput Med Imag, 2013, 19 (6) :519-523. (in Chinese) 沈慧娟, 曾宪智, 刘义军, 等.CT单能量成像在肝图像质量和诊断中的价值[J].中国医学计算机成像杂志, 2013, 19 (6) :519-523.
    [7]ZHAO LQ, HE W, LI JY, et al.Improving image quality in porta venography with spectral CT imaging[J].Eur J Radiol, 2012, 81 (8) :1677-1681.
    [8]SU L, DONG J, SUN Q, et al.Spectral CT imaging in patients with Budd-Chiari syndrome:investigation of image quality[J].Cell Biochem Biophys, 2014, 70 (2) :1043-1049.
    [9]LYU PJ.Small hepatocellular carcinoma:detection with optimal monochromatic energy of spectral imaging[J].Radiol Pract, 2011, 26 (3) :321-324. (in Chinese) 吕培杰.CT能谱成像在小肝癌检测中的应用价值[J].放射学实践, 2011, 26 (3) :321-324.
    [10]LIU JH, LIU AL, TIAN SF, et al.Evaluation of quality of CT angiography on cystic artery with low concentration contrast medium optimizing gemstone spectral imagine technique with spectral CT[J].Chin J Med Imaging Technol, 2014, 30 (7) :1091-1094. (in Chinese) 刘静红, 刘爱连, 田士峰, 等.低浓度对比剂结合能谱CT最佳单能量成像对胆囊动脉的显示能力[J].中国医学影像技术, 2014, 30 (7) :1091-1094.
    [11]ZHANG W.Study on the significance of precious stone energy spectrum CT imaging in diagnosis of different tissue sources and pathological types of tumors and metastasis in lymph nodes[J].J Clin Exp Med, 2016, 15 (8) :813-815. (in Chinese) 张武.宝石能谱CT成像在不同组织来源、病理类型肿瘤及其转移淋巴结中的诊断价值[J].临床和实验医学杂志, 2016, 15 (8) :813-815.
    [12]JIANG F, DENG KX, ZHAO N, et al.Child-Pugh grading in cirrhosis patients with spectral CT[J].Chin Comput Med Imag, 2015, 21 (1) :48-52. (in Chinese) 江帆, 邓克学, 赵娜, 等.能谱CT成像应用于肝硬化Child-Pugh分级[J].中国医学计算机成像杂志, 2015, 21 (1) :48-52.
    [13]LI XG.The value of gemstone spectral CT in differential diagnosis of hepatic hemangioma and metastasis[D].Hebei:Hebei Medical University, 2015. (in Chinese) 李晓光.宝石能谱CT在鉴别肝脏血管瘤与转移瘤中的应用价值[D].河北:河北医科大学, 2015.
    [14]GUAN CX, SONG RJ, ZHANG XS.Dual energy spectral CT diagnostic value of liver abscess[J].JPMI, 2015, 16 (5) :423-425. (in Chinese) 关长旭, 宋瑞娟, 张旭升.宝石能谱CT对肝脓肿诊断的价值[J].实用医学影像杂志, 2015, 16 (5) :423-425.
    [15]LI H, HE D, LAO Q, et al.Clinical value of spectral CT in diagnosis of negative gallstones and common bile duct stones[J].Abdom Imaging, 2015, 40 (6) :1587-1594.
    [16]REN XL, LIU Y, WANG XJ, et al.Spectral CT imagine for the assessment of non-calcified plaque compositions in carotid atherosclerosis[J].Chin J Med Imaging Technol, 2013, 29 (2) :202-205. (in Chinese) 任小璐, 刘云, 王杏娟, 等.能谱CT评估颈动脉粥样硬化非钙化斑块成分[J].中国医学影像技术, 2013, 29 (2) :202-205.
    [17]JIANG S, WANG XY, JIANG ZF.Research progress of enemy spectrum CT in the diagnosis of liver cancer[J/CD].Chin J Digest Med Imageol:Electronic Edition, 2014, 4 (3) :145-148. (in Chinese) 姜舒, 王新怡, 姜召福.能谱CT在肝癌诊断中的研究进展[J/CD].中华消化病与影像杂志:电子版, 2014, 4 (3) :145-148.
    [18]BROWN CL, HARTMAN RP, DZYUBAK OP, et al.Dual-enery CT iodine overlay technique for characterization of renal masses as cyst or solid:a phantom feasibility study[J].Eur Radiol, 2009, 19 (5) :1289-1295.
    [19]APFALTRER P, MEYER M, MRIER C, et al.Contrast-enhanced dual-energy CT of gastrointestinal stromal tumors:is iodine-related attenuation a potential indicator of tumor response?[J].Invest Radiol, 2012, 47 (1) :65-70.
    [20]LV P, LIN XZ, CHEN K, et al.Spectral CT in patients with small HCC:investigation of image quality and diagnostic accuracy[J].Eur Radiol, 2012, 22 (10) :2117-2124.
    [21]LV PJ, LIN XZ, GAO JB, et al.Spectral CT:preliminary studies in the liver cirrhosis[J].Korean J Radiol, 2012, 13 (4) :434-442.
    [22]ZHENG X, REN Y, PHILLIPS WT, et al.Assessment of hepatic fatty infiltration using spectral computed tomography imaging:a pilo study[J].J Comput Assist Tomogr, 2013, 37 (2) :134-141.
    [23]CHEN AL, LIU AL, WANG S, et al.Detection of gallbladder stones by dual-energy spectral computed tomography imaging[J].World J Gastroenterol, 2015, 21 (34) :9993-9998.
    [24]KAZA RK, CAOILI EM, COHAN RH, et al.Distinguishing enhancing from non-enhancing renal lesions with fast kilovoltage switching dual energy CT[J].AJR Am J Roentgenol, 2011, 197 (6) :1375-1381.
    [25]ASCENTI G, SOFIA C, MAZZIOTTI S, et al.Dual-energy CT with iodine quantification in distinguishing between bland and neoplastic portal vein thrombosis in patients with hepatocellular carcinoma[J].Clin Radiol, 2016, 71 (9) :938.e1-e9.
    [26]ZHAO LQ, HE W, YAN B, et al.The evaluation of haemodynamics in cirrhotic patients with spectral CT[J].Br J Radiol, 2013, 86 (1028) :20130228.
    [27]WANG F, SHEN JL, HUA J, et al.Studies of the application o spectral CT evaluating the grading of esophageal varices of liver cirrhosis[J].J Clin Radiol, 2016, 35 (2) :208-212. (in Chinese) 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[J].临床放射学杂志, 2016, 35 (2) :208-212.
    [28]YAN FH.Research advances in computed tomography and magnetic resonance imaging findings of cirrhotic portal hypertension[J].JClin Hepatol, 2016, 32 (6) :1079-1082. (in Chinese) 严福华.肝硬化门静脉高压CT和磁共振成像的表现及研究进展[J].临床肝胆病杂志, 2016, 32 (6) :1079-1082.
    [29]WU XW, WANG WQ, WANG L, et al.A study of CT monochromatic imaging for quantitative detecting hemoglobin levels[J].J X-ray Sci Technol, 2012, 20 (4) :483-488.
    [30]PENG XY, LI JH, ZHAO J, et al.Distribution of calcium deposits in the pericystic layers of hepatic hydatid cyst and its significances[J].Chin J Zoonoses, 2006, 22 (9) :825-827, 832. (in Chinese) 彭心宇, 李建辉, 赵瑾, 等.肝细粒棘球蚴周围纤维囊壁钙化分布及意义[J].中国人兽共患病学报, 2006, 22 (9) :825-827, 832.
    [31]YE L, YE YL, RAN GL, et al.Gemstone spectral CT imaging mechanism and clinical application[J/CD].Chin J Clinicians:E-lectronic Edition, 2013, 7 (19) :8919-8921. (in Chinese) 叶伦, 叶奕兰, 冉艮龙, 等.宝石能谱CT的成像原理及临床应用[J/CD].中华临床医师杂志:电子版, 2013, 7 (19) :8919-8921.
    [32]SUN T, LIN X, CHEN K.Evaluation of hepatic steatosis using dua-energy CT with MR comparison[J].Front Biosci (Landmark Ed) , 2014, 19 (5) :1377-1385.
    [33]HUANG W, TIAN T, SUN GP.Clinical application of gemstone spectral CT-imaging to identification and diagnosis of differen pathological types of tumors and their metastatic lymph nodes[J].Anhui Med Pharm J, 2013, 17 (11) :1877-1880. (in Chinese) 黄玮, 田添, 孙国平.宝石能谱CT成像在鉴别不同病理类型肿瘤及其转移淋巴结中的作用[J].安徽医药, 2013, 17 (11) :1877-1880.
    [34]YANG CH, YU DX, WANG LL, et al.Values of spectral CT imaging in differential diagnosis of hepatic carcinoma and liver metastasis[J].J Med Imaging, 2014, 24 (11) :1931-1935. (in Chinese) 杨传红, 于德新, 王琳琳, 等.CT能谱成像在肝细胞癌与肝转移瘤鉴别中的价值[J].医学影像学杂志, 2014, 24 (11) :1931-1935.
    [35]HUANG KF, ZHOU BC, HUANG JS, et al.Prospective study on component analysis of isolated urinary calculus by effective average atomic number of energy spectrum CT[J].Clin J Med Offic, 2011, 39 (4) :615-617. (in Chinese) 黄科峰, 周宝成, 黄金山, 等.能谱CT有效平均原子序数对离体尿路结石成分分析的前瞻性研究[J].临床军医杂志, 2011, 39 (4) :615-617.
    [36]ZHANG JH, YANG KZ, HAN BL.The kinetic mechanism of gallstone formation[J].Chin J Gen Surg, 2001, 16 (7) :424-426. (in Chinese) 张继红, 杨可桢, 韩本立.胆囊结石形成的动力学机制[J].中华普通外科杂志, 2001, 16 (7) :424-426.
    [37]de CECCO CN, MUSCOGIURI G, SCHOEPF UJ, et al.Virtual unenhanced imaging of the liver with third-generation dualsource dual-energy CT and advanced modeled iterative reconstruction[J].Eur J Radiol, 2016, 85 (7) :1257-1264.
    [38]LIU XT.Research of differential diagnosis value by CT spectral imaging for focal liver lesion[J].China Prac Med, 2016, 11 (26) :17-18. (in Chinese) 刘新田.CT能谱成像对肝脏局灶性病变鉴别诊断价值的研究[J].中国实用医药, 2016, 11 (26) :17-18.
    [39]LV P, LIN XZ, LI J, et al.Differentiation of small hepatic hemangioma from small hepatocellular carcinoma:recently introduced spectral CT method[J].Radiology, 2011, 259 (3) :720-729.
    [40]YANG L, WANG SA, ZHU QQ, et al.Spectral CT imagine in differentiation of liver small cysts from micro-metastatic lesions[J].Chin J Med Imaging Technol, 2013, 29 (1) :92-96. (in Chinese) 杨璐, 王守安, 朱庆强, 等.CT能谱成像鉴别肝脏微小转移瘤与小囊肿[J].中国医学影像技术, 2013, 29 (1) :92-96.
    [41]ZHENG S, TANG YM, YANG JH, et al.Spectral CT imaging in differential diagnosis of hepatocellular carcinoma and focal nodular hyperplasia[J].J Pract Hepatol, 2013, 16 (5) :411-415. (in Chinese) 郑盛, 唐映梅, 杨晋辉, 等.CT能谱成像鉴别肝癌和肝脏局灶性结节增生的临床价值[J].实用肝脏病杂志, 2013, 16 (5) :411-415.
    [42]JIANG S.Preliminary application of spectral CT imaging in the pathological differentiation of hepatocellular carcinoma[D].Shandong:Shandong University, 2014. (in Chinese) 姜舒.CT能谱成像在肝细胞肝癌病理分化程度中的初步应用[D].山东:山东大学, 2014.
    [43]LIU CX, ZHANG CQ, WANG XY, et al.Application value of spectral CT imaging in differential diagnosis of hepatocellular carcinoma and hepatic mass-type cholangiocarcinoma[J].J Shandong Univ:Med Sci Edit, 2014, 52 (12) :94-98. (in Chinese) 刘常绪, 张成琪, 王新怡, 等.能谱CT在肝细胞癌与肝内肿块型胆管细胞癌鉴别诊断中的应用价值[J].山东大学学报:医学版, 2014, 52 (12) :94-98.
    [44]FENG Q, LI Q, HU Y, et al.Small colorectal cancer liver metastases:clinical value of quantitative iodine-based material decomposition images of spectral CT[J].World Chin J Dig, 2016, 24 (15) :2421-2428. (in Chinese) 冯琴, 李琼, 胡瑶, 等.小结直肠癌肝转移:能谱CT碘定量量化增强特点[J].世界华人消化杂志, 2016, 24 (15) :2421-2428.
    [45]YU Y, HE N, SUN K, et al.Differentiating hepatocellular carcinoma from angiomyolipoma of the liver with CT spectral imaging:a preliminary study[J].Clin Radiol, 2013, 68 (9) :491-497.
    [46]LI TT, JIANG Y, LIU WY, et al.Spectral CT imaging in differential diagnosis of hepatic cyst and unilocular hepatic cystic echinococcosis[J].Chin J Med Imaging Technol, 2015, 31 (9) :1344-1348. (in Chinese) 李婷婷, 蒋奕, 刘文亚, 等.能谱CT鉴别诊断肝脏单纯囊肿和单房囊性包虫病[J].中国医学影像技术, 2015, 31 (9) :1344-1348.
    [47]YU Y, GUO L, HU C, et al.Spectral CT imaging in the differential diagnosis of necrotic hepatocellular carcinoma and hepatic abscess[J].Clin Radiol, 2014, 69 (12) :517-524.
    [48]ZONG ZJ, WANG JP, JIANG WY, et al.The value of spectral CTin diagnosis different benign and malignant pancreatic cystic tumor[J].Chin J Lab Diagn, 2015, 19 (2) :262-263. (in Chinese) 宗子健, 王继萍, 姜文琰, 等.宝石能谱CT对不同良恶性胰腺囊性肿瘤的诊断价值[J].中国实验诊断学, 2015, 19 (2) :262-263.
    [49] XING JJ, CHAI YR, GAO JB, et al.Application of spectral CT in the differentiation of stage T3 and T4a gastric carcinoma[J].Chin JGastrointest Surg, 2016, 19 (5) :580-584. (in Chinese) 邢静静, 柴亚如, 高剑波, 等.能谱CT在鉴别T3及T4a期胃癌中的应用价值[J].中华胃肠外科杂志, 2016, 19 (5) :580-584.
    [50]LI HX, ZHU K, SUN CY, et al.Application of gemstones spectral CT in reducing metal artifacts[J].China Med Herald, 2015, 12 (11) :42-45. (in Chinese) 李昊翔, 朱凯, 孙重阳, 等.宝石能谱CT在减少金属伪影方面的应用进展[J].中国医药导报, 2015, 12 (11) :42-45.
    [51]NING P, ZHU S, SHI D, et al.X-ray dose reduction in abdominal computed tomography using advanced iterative reconstruction algorithms[J].PLoS One, 2014, 9 (3) :e92568.
    [52]MA CL, CHEN XX, LEI YX, et al.Clinical value of dual-energy spectral imaging with adaptive statistical iterative reconstruction for reducing contrast medium dose in CT portal venography:in comparison with standard 120-k Vp imaging protocol[J].Br J Radiol, 2016, 89 (1062) :1022-1024.
    [53]MULLNER M, SCHLATTL H, HOESCHEN C, et al.Feasibility of spectral CT imaging for the detection of liver lesions with goldbased contrast agents-a simulation study[J].Phys Med, 2015, 31 (8) :875-881.
    [54]JI H.Study on the portal vein imaging and radiation dose of the spectral CT[D].Jilin:Jilin University, 2015. (in Chinese) 纪红.能谱CT分团注射门静脉成像及辐射剂量的研究[D].吉林:吉林大学, 2015.
    [55]ZHAI YN, LI L, YIN L, et al.Role of dual-source CT low-dose whole liver perfusion imaging in evaluating liver blood perfusion after transjugular intrahepatic portosystemic shunt in cirrhotic patients with portal hypertension[J].J Clin Hepatol, 2016, 32 (10) :1894-1899. (in Chinese) 翟亚楠, 李雷, 殷亮, 等.双源CT全肝低剂量灌注成像对肝硬化门静脉高压患者经颈静脉肝内门体分流术后肝血流灌注的评估价值[J].临床肝胆病杂志, 2016, 32 (10) :1894-1899.
    [56]ZHOU Y, WANG MY, GAO JB, et al.Evaluation of efficacy of anti-angiogenesis therapy for VX2 hepatic tumors in rabbits by spectral CT and CT perfusion imaging[J].World Chin J Dig, 2014, 22 (31) :4726-4733. (in Chinese) 周悦, 王明月, 高剑波, 等.宝石CT能谱成像及灌注成像评价兔VX2肝癌抗血管生成的治疗疗效[J].世界华人消化杂志, 2014, 22 (31) :4726-4733.
    [57]DAI X, SCHLEMMER HP, SCHMDT B, et al.Quantitative therapy response assessment by volumetric iodine-uptake measurement:initial experience in patients with advanced hepatocellular carcinoma treated with sorafenib[J].Eur J Radiol, 2013, 82 (2) :327-334.
    [58]YUE QQ, WANG XY.Progress of imaging in evaluating the efficiency of molecular targeted therapy in hepatocellular carcinoma[J/CD].Chin J Clinicians:Electronic Edition, 2016, 10 (9) :1312-1316. (in Chinese) 岳倩倩, 王新怡.肝细胞肝癌分子靶向治疗的影像学评价进展[J/CD].中华临床医师杂志:电子版, 2016, 10 (9) :1312-1316.
    [59]LV P, LIU J, YAN X, et al.CT spectral imaging for monitoring the therapeutic efficacy of VEGF receptor kinase inhibitor AG-013736in rabbit VX2 liver tumours[J].Eur Radiol, 2016.[Epub ahead of print]
    [60]LIU QY, HE CD, ZHOU Y, et al.Application of gemstone spectral imaging for efficacy evaluation in hepatocellular carcinoma after transarterial chemoembolization[J].World J Gastroenterol, 2016, 22 (11) :3242-3251.
    [61]VANDENBROUCKE F, van HEDENT S, van GOMPEL G, et al.Dual-energy CT after radiofrequency ablation of liver, kidney, and lung lesions:a review of features[J].Insights Imaging, 2015, 6 (3) :363-379.
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  • 收稿日期:  2016-10-13
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