CT能谱成像鉴别膀胱后壁癌与前列腺增生突入膀胱

摘要

目的 探讨宝石CT能谱成像(GSI)鉴别膀胱后壁癌与前列腺增生突向膀胱内的价值.方法 收集接受GSI检查并经病理证实的20例膀胱后壁癌及21例突入膀胱内的前列腺增生患者,分别以40～140 keV条件下在病灶及前列腺组织内取ROI,获得4组不同keV水平的CT值及CT能谱曲线；分析其差异,计算膀胱后壁癌与前列腺增生突入膀胱内的能谱曲线斜率.结果 50～70 keV条件下,膀胱后壁癌与前列腺组织的CT值差异无统计学意义,其他keV条件下差异有统计学意义,100 keV时CT值差异最大(t=-5.776,P=0.002).前列腺增生突入膀胱内与前列腺组织之间不同keV条件下CT值差异均无统计学意义.膀胱后壁癌与前列腺增生突入膀胱内的CT值在60～90 keV时差异无统计学意义,在其他keV条件下差异均有统计学意义,以40 keV条件下差异最大(t=-4.711,P=0.001).膀胱后壁癌能谱曲线斜率(k=0.86)明显大于前列腺增生突入膀胱内曲线斜率(k=0.25).结论 CT能谱成像可较准确地区分膀胱后壁癌与前列腺增生突入膀胱内.%Objective To investigate value of gemstone spectral imaging (GSI) for differential diagnosis of posterior wall bladder cancer from prostate hyperplasia into bladder. Methods Twenty patients with posterior wall bladder cancers and 21 patients with prostate hyperplasias into the bladder underwent GSI from 40 to 140 keV. ROIs were selected on the center of the lesions and prostate tissue, respectively. The mean CT value of ROI was measured, the spectrum curve was drawn, and the differences were evaluated statistically. Results At 50-70 keV, no statistical difference of the mean CT value was found between posterior wall bladder cancer and prostate tissue, while statistical differences were found under the rest keV conditions, which was most obvious at 100 keV (t= - 5. 776, P = 0. 002). There was no statistical difference between prostate and prostate hyperplasia into the bladder. No statistical difference of the mean CT value between posterior wall bladder cancer and prostate hyperplasia was found at 60-90 keV, while statistical differences were found under the rest keV conditions, which was most obvious at 40 keV (t= -4. 711, P = 0. 001). The slope of energy spectrum curve of posterior wall bladder cancer (k= 0. 86) was significantly greater than that of prostate hyperplasia into the bladder (k = 0. 25). Conclusion GSI can differentiate posterior wall bladder cancer from prostate hyperplasia into the bladder with high accuracy.