Li Junwei,Zhuang Xiamei,Yin Yan,et al.Comparative study of spectral CT virtual plain scan versus actual plain scan in diagnosing pediatric skeletal muscle tumors/tumor-like lesions[J].Journal of Clinical Pediatric Surgery,2024,(04):387-392.[doi:10.3760/cma.j.cn101785-202403060-016]
能谱CT虚拟平扫与真实平扫诊断儿童骨骼肌肿瘤或肿瘤样病变的对比研究
- Title:
- Comparative study of spectral CT virtual plain scan versus actual plain scan in diagnosing pediatric skeletal muscle tumors/tumor-like lesions
- Keywords:
- Muscle; Skeletal; Muscle Neoplasms; Tumors/Tumor-Like Lesions; Tomography; X-ray computed; Virtual Non-contrast; Child
- 摘要:
- 目的 比较骨骼肌肿瘤/肿瘤样病变患儿行能谱CT虚拟平扫(virtual non-contrast,VNC)和真实平扫(true non-contrast,TNC)的影像特征以及影像质量,探讨能谱CT VNC用于儿童骨骼肌肿瘤/肿瘤样病变诊断的准确性与可行性。 方法 回顾性分析湖南省儿童医院放射科2020年1月至2021年12月行能谱CT平扫及双期增强扫描的43例骨骼肌肿瘤/肿瘤样病变患儿影像学资料,经后处理获得动脉期VNC图像(VNCa)与静脉期VNC图像(VNCv)。分别在TNC、VNCa与VNCv图像上测得病灶最大层面及同层面正常骨骼肌及脂肪的CT值与标准差(standard deviation,SD),计算信噪比(signal noise ratio,SNR)及对比噪声比(contrast noise ration,CNR),比较三种图像的图像质量和诊断效能。 结果 三种图像中骨骼肌病灶与骨骼肌的CT值差异均无统计学意义(骨骼肌病灶:F=2.139,P=0.122;骨骼肌:F=0.663,P=0.517)。VNCv比TNC的SNR值高,差异有统计学意义(P<0.01)。TNC图像与VNC图像中骨骼肌肿瘤/肿瘤样病变的病灶CT征象差异无统计学意义(P>0.05)。两名观察者对三种图像的主观评分结果一致性好(TNC:κ=0.554;VNCa:κ=0.501;VNCv:κ=0.628)。正常骨骼肌VNCa、VNCv与TNC图像CT值一致性良好(平均差值:VNCa=1.330 HU,VNCv=0.518 HU),骨骼肌病灶VNCv与TNC图像CT值一致性好(平均差值=-3.870 HU)。 结论 能谱CT VNC技术对儿童骨骼肌肿瘤/肿瘤样病变的诊断具有与TNC相似的图像质量和诊断价值,可减少一期常规平扫次数、降低辐射剂量。
- Abstract:
- Objective To compare the imaging characteristics and qualities of spectral computed tomography (CT) virtual non-contrast (VNC) versus true non-contrast (TNC) scans for pediatric skeletal muscle tumors/tumor-like lesions and explore the accuracy and feasibility of using spectral CT VNC for diagnosing these conditions. Methods A retrospective analysis was conducted for the radiological data of 43 children with skeletal muscle tumors/tumor-like lesions receiving spectral CT plain and dual-phase enhancement scans.Then the raw data were processed into VNCa and VNCv.Also the corresponding normal skeletal muscle and fat on TNC,VNCa and VNCv images were measured.Signal noise ratio (SNR) and contrast noise ratio (CNR) were calculated for comparing the image quality and diagnostic efficacy of three types of images. Results No statistically significant difference existed in CT values of skeletal muscle and skeletal muscle lesions among three types of images (skeletal muscle:F=0.663,P=0.517;skeletal muscle lesions:F=2.139,P=0.122).SNR value of VNCv was significantly higher than that of TNC (P<0.01).No statistically significant difference existed in CT signs of skeletal muscle tumors/tumor-like lesions between TNC and VNC images (P>0.05).The subjective scoring consistency of three types of images by two observers was excellent (TNC:κ=0.554;VNCa:κ=0.501;VNCv:κ=0.628).The consistency of CT values of normal skeletal muscle between VNCa,VNCv and TNC images was excellent (average difference:VNCa=1.330 HU,VNCv=0.518 HU).And the consistency of CT values of skeletal muscle lesions between VNCv and TNC images was also decent (average difference=-3.870 HU). Conclusions Spectral CT VNC technology has demonstrated similar image quality and diagnostic value to TNC in diagnosing pediatric skeletal muscle tumors/tumor-like lesions.It may minimize the number of routine plain scans and lower radiation dosage.
参考文献/References:
[1] Nystrom LM,Reimer NB,Dean CW,et al.Evaluation of imaging utilization prior to referral of musculoskeletal tumors:a prospective study[J].J Bone Joint Surg Am,2015,97(1):10-15.DOI:10.2106/JBJS.N.00186.
[2] 黄仁军,李勇刚.能谱CT的临床应用与研究进展[J].放射学实践,2015,30(1):81-83.DOI:10.13609/j.cnki.1000-0313.2015.01.022. Huang RJ,Li YG.Clinical applications and research advances of energy spectrum CT[J].Radiologic Practice,2015,30(1):81-83.DOI:10.13609/j.cnki.1000-0313.2015.01.022.
[3] [JP2] 袁源,郎宁,袁慧书.CT能谱曲线在脊柱转移瘤和感染性病变中的鉴别诊断价值[J].北京大学学报(医学版),2021,53(1):183-187.DOI:10.19723/j.issn.1671-167X.2021.01.027.[JP] Yuan Y,Lang N,Yuan HS.CT spectral curve in differentiating spinal tumor metastasis and infections[J].J Peking Univ (Health Sci),2021,53(1):183-187.DOI:10.19723/j.issn.1671-167X.2021.01.027.
[4] 徐月,何东,周敏,等.能谱CT在良恶性肾脏囊性占位中的诊断价值[J].中国临床医学影像杂志,2021,32(9):644-647,659.DOI:10.12117/jccmi.2021.09.009. Xu Y,He D,Zhou M,et al.Diagnostic values of spectral CT in benign and malignant cystic renal masses[J].J Chin Clin Med Imaging,2021,32(9):644-647,659.DOI:10.12117/jccmi.2021.09.009.
[5] Zhang XL,Bai LC,Wang D,et al.Gastrointestinal stromal tumor risk classification:spectral CT quantitative parameters[J].Abdom Radiol (NY),2019,44(7):2329-2336.DOI:10.1007/s00261-019-01973-w.
[6] Dong Y,Zheng SW,Machida H,et al.Differential diagnosis of osteoblastic metastases from bone islands in patients with lung cancer by single-source dual-energy CT:advantages of spectral CT imaging[J].Eur J Radiol,2015,84(5):901-907.DOI:10.1016/j.ejrad.2015.01.007.
[7] Uhl M,Herget G,Hettmer S,et al.Bone and soft tissue tumours in children:proposal for a rational diagnostic approach[J].Radiologe,2021,61(7):649-657.DOI:10.1007/s00117-021-00859-7.
[8] 程璐,朱唯玮,李芋亭,等.探讨GE Revolution能谱扫描上腹部虚拟平扫代替常规平扫可行性[J].影像研究与医学应用,2020,4(11):105-107. Cheng L,Zhu WW,Li YT,et al.Exploring the feasibility of GE Revolution energy spectrum scanning for virtual plain scanning of upper abdomen instead of conventional plain scanning[J].J Imaging Res Med Appl,2020,4(11):105-107.
[9] Bonatti M,Lombardo F,Zamboni GA,et al.Dual-energy CT of the brain:comparison between DECT angiography-derived virtual unenhanced images and true unenhanced images in the detection of intracranial haemorrhage[J].Eur Radiol,2017,27(7):2690-2697.DOI:10.1007/s00330-016-4658-y.
[10] 郑星星,冯峰,丁勇生,等.双源能谱CT虚拟平扫替代常规平扫评估食管癌的可行性研究[J].国际医学放射学杂志,20,2043(2):150-155.DOI:10.19300/j.2020.L17479.[JP2] Zheng XX,Feng F,Ding YS,et al.Feasibility of using dual-source energy spectrum CT virtual non-contrast instead of true non-contrast scan for evaluating esophageal cancer[J].Int J Med Radiol,2020,43(2):150-155.DOI:10.19300/j.2020.L17479.[JP]
[11] Borhani AA,Kulzer M,Iranpour N,et al.Comparison of true unenhanced and virtual unenhanced (VUE) attenuation values in abdominopelvic single-source rapid kilovoltage-switching spectral CT[J].Abdom Radiol (NY),2017,42(3):710-717.DOI:10.1007/s00261-016-0991-5.
[12] Liang ES,Wastney T,Dobeli K,et al.Virtual non-contrast detector-based spectral CT predictably overestimates tissue density for the characterisation of adrenal lesions compared to true non-contrast CT[J].Abdom Radiol (NY),2022,47(7):2462-2467.DOI:10.1007/s00261-022-03528-y.
[13] [JP3] 苏蕾,牛志兴,高剑波,等.能谱CT虚拟平扫图像在腮腺肿瘤检出及显示中的可行性[J].中国医学影像学杂志,2019,27(2):124-127,130.DOI:10.3969/j.issn.1005-5185.2019.02.010.[JP] Su L,Niu ZX,Gao JB,et al.Feasibility of energy spectral CT virtual non-contrast images in detecting and visualizing parotid tumors[J].Chin J Med Imaging,2019,27(2):124-127,130.DOI:10.3969/j.issn.1005-5185.2019.02.010.
[14] 林禹,张潇潇,张有彬,等.双层探测器光谱CT虚拟平扫应用于肝脏三期增强扫描[J].中国医学影像技术,2020,36(S1):29-33.DOI:10.13929/j.issn.1003-3289.2020.z1.007. Lin Y,Zhang XX,Zhang YB,et al.Application of dual-layer spectral detector CT virtual non-contrast images in hepatic triple-phase enhanced scan[J].Chin J Med Imaging Technol,2020,36(S1):29-33.DOI:10.13929/j.issn.1003-3289.2020.z1.007.
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[1]麻晓鹏,王涛,祖莹,等.肺动脉平滑肌细胞钙含量与先心病肺动脉高压的关联性研究[J].临床小儿外科杂志,2008,7(01):9.
备注/Memo
收稿日期:2023-03-31。
通讯作者:金科,Email:jinke001@sina.com