双源ct双能量虚拟平扫在肺癌诊断中的初步研究

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1、遵义医学院硕士学位论文刘江勇中图法分类号：R814.42学校代码：10661学号：2011311密级：公开硕士学位论文（专业型学位）双源CT双能量虚拟平扫在肺癌诊断中的初步研究Apreliminarystudyofdual-energyvirtualnon-contrastCTofdualsourceCTinthediagnosisoflungcancer姓名：刘江勇专业：影像医学与核医学研究方向：胸部影像诊断导师：骆科进教授培养单位：遵义医学院2014年5月万方数据万方数据遵义医学院硕士学位论文刘江勇目录1.论文：„

2、„„„„„„„„„„„„„„„„„„„„„„„1中英缩略词对照表„„„„„„„„„„„„„„„„„„„1中文摘要„„„„„„„„„„„„„„„„„„„„„„„2英文摘要„„„„„„„„„„„„„„„„„„„„„„„3前言„„„„„„„„„„„„„„„„„„„„„„„„„5材料与方法„„„„„„„„„„„„„„„„„„„„„„7结果„„„„„„„„„„„„„„„„„„„„„„„„„9讨论„„„„„„„„„„„„„„„„„„„„„„„„„14结论„„„„„„„„„„„„„„„„„„„„„„„„„17参考文献„„„„„„„„

3、„„„„„„„„„„„„„„„182.综述：„„„„„„„„„„„„„„„„„„„„„„„„203.致谢：„„„„„„„„„„„„„„„„„„„„„„„„304.作者简介：„„„„„„„„„„„„„„„„„„„„„„31万方数据遵义医学院硕士学位论文刘江勇中英文缩略词表缩略词英文全称中文全称ACSAmericanCancerSociety美国癌症协会CNRContrast-to-NoiseRatio对比噪声比CTX-rayComputedTomographyX线计算机体层成像CTDIvolComputedTomogra

4、phyDoseIndexvolume容积CT剂量指数DECTDualEnergyComputedTomography双能量CTDLPDose-lengthProduct剂量长度乘积DSCTDualSourceComputedTomography双源CTEDEffectiveDose有效剂量FOVFieldOfView视野MRIMagneticResonanceImaging磁共振成像PETPositronEmissionTomography正电子发射体层成像ROIRegionOfInterest感兴趣区SNRSigna

5、ltoNoiseRatio信噪比VNCVirtualNon-Contrast虚拟平扫1万方数据遵义医学院硕士学位论文刘江勇双源CT双能量虚拟平扫在肺癌诊断中的初步研究中文摘要目的：探讨双源CT双能量虚拟平扫（VNC）技术在肺癌诊断中的价值。方法：对50例疑似肺癌患者（其中后经病理证实为肺癌34例）行常规CT平扫和双能量CT增强扫描。观察50例患者的常规CT平扫图像与VNC图像，测量降主动脉、左心房及胸椎椎体后方肌肉的平均CT值，计算信噪比（SNR），并对两组数据进行配对t检验；评价图像质量以常规平扫图像作为参考图像进行

6、评分。使用LiverVNC软件程序获得肺癌肿块的VNCCT值及增强净增值。以CT值净增值≥20HU的肿块诊断肺癌作为标准，对34例确诊肺癌病例进行评价，计算诊断准确性。比较常规扫描与双能量扫描患者辐射剂量。结果：50例患者降主动脉的常规CT平扫与VNC平均CT值分别为（45.13±3.90，1.±3.13），（P＜0.05），差异有统计学意义；左心房平均CT值分别为（44.99±4.65，46.08±3.56），（P＞0.05）；胸椎椎体后方肌肉平均CT值平均CT值分别为（46.18±2.01，46.44±2.33），

7、（P＞0.05），差异无统计学意义。常规平扫降主动脉、左心房及胸椎椎体后方肌肉的SNR分别为11.57±1.00，9.68±1.00，22.98±1.00；VNC降主动脉、左心房及胸椎椎体后方肌肉的SNR分别为15.02±1.00，13.71±1.06，19.93±1.00，三组数据两两比较P值均＜0.05，差异有统计学意义。50例常规平扫图像与VNC图像的质量评分平均得分分别为4.65±0.48，4.60±0.50，(P＞0.05),两组间差异无统计学意义。34例经过最终病理证实为肺癌的病灶CT值的净增值为38.69

8、±18.3HU，以净增值≥20HU诊断肺癌为标准，准确率为94.1%（32/34）。比较常规扫描与双能量扫描患者剂量，虽然VNC的CTDIvol、DLP、ED均稍高于常规平扫，差异具有统计学意义（P＜0.05），但运用VNC技术节省一次常规平扫剂量，平均每人可减少2.29mSv有效剂量。结论：双源CT双能量VNC技术应用于胸部扫描