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目的探讨肾上腺皮质腺瘤宽体探测器CT灌注成像特点。方法回顾性分析21例经病理证实的肾上腺皮质腺瘤患者的宽体探测器CT扫描资料。CT灌注(CTP)扫描采用16cm探测器覆盖的轴扫模式,ASiR-V50%,注射对比剂6s后开始行CTP数据采集,共采集26期图像,在第22s、51s及153s获取动脉期、静脉期及延迟期增强图像。测量肾上腺腺瘤(A组)和对侧正常肾上腺结合部(B组)的血流量(BF)、血容量(BV)、平均通过时间(MTT)、达峰时间(TP)及表面通透性(PS)值。比较2组间各参数值的差异,并评价辐射剂量。应用ROC曲线分析CT灌注参数对肾上腺腺瘤的诊断效能。结果 A组的BV、MTT及PS值均低于B组(P均<0.05),2组间BF、TP值差异无统计学意义(P均>0.05)。以BV、MTT及PS值诊断肾上腺腺瘤的ROC曲线下面积(AUC)分别为0.780、0.762及0.831,以PS值1.37ml/(100g·min)为阈值诊断腺瘤的敏感度为95.2%,特异度为81.0%。平扫、CTP(含增强三期)的有效辐射剂量(ED)分别为(3.20±0.57)、(19.98±1.95)。结论宽体探测器CT灌注成像可为诊断肾上腺皮质腺瘤提供高质量常规三期强化图像,同时提供有效的定量灌注数据。PS值对腺瘤有较高诊断效能。
Objective To investigate the characteristics of CT perfusion imaging of wide-body adrenocortical adenoma. Methods A retrospective analysis of 21 cases of pathologically confirmed adrenal adenoma in patients with wide-body CT scan data. CT perfusion (CTP) scan using a 16cm detector covered axis scan mode, ASiR-V50%, 6s after injection of contrast agent CTP data acquisition, a total of 26 images were collected at the 22s, 51s and 153s to obtain the arterial phase, Period and delay enhance images. The blood flow (BF), blood volume (BV), mean transit time (MTT), peak time (TP) and surface permeability of adrenal adenoma (group A) and contralateral normal adrenal junction (group B) (PS) value. The differences between the two groups were compared, and the radiation dose was evaluated. Analysis of CT perfusion parameters on the diagnosis of adrenal adenoma using ROC curve. Results The BV, MTT and PS values in group A were lower than those in group B (all P <0.05). There was no significant difference in BF and TP between the two groups (all P> 0.05). The area under the ROC curve (AUC) for diagnosis of adrenal adenomas with BV, MTT and PS values were 0.780, 0.762 and 0.831, respectively. The sensitivity of adenoma with the value of 1.37ml / (100g · min) was 95.2% The specificity was 81.0%. The effective radiation dose (ED) of plain scan and CTP (including enhanced three phases) were (3.20 ± 0.57) and (19.98 ± 1.95), respectively. Conclusion The wide body CT perfusion imaging can provide high-quality conventional three-stage enhanced images for diagnosis of adrenocortical adenoma and provide effective quantitative perfusion data. PS value of adenoma has a higher diagnostic efficacy.