| Objective: Evaluation of gem spectrum imaging id injection periodenhanced CT scan of renal clear cell carcinoma of the display and theinspectors research of radiation dose。Materials and methods: According to the experiment, collected in July2013to February2014, the abdomen colour to exceed diagnose for patientswith renal placeholder, double kidney stones energy spectrum CT scan andenhanced inspections. According to the patients with check sequence, dividedthe patients into two groups at random, kidney adult single period injectionenhancement scanning group (experimental group) and renal single injection ofdual phase dynamic enhanced scan group (control group). Experimental group20cases, control group20cases, a total of40cases, has the complete energyspectrum CT examination data and postoperative pathologic results.14cases ofexperimental group: men, women6cases; The average age was55.11±13.47years old; The left kidney tumor9cases, right kidney tumors11cases. Controlgroup: male12, female8; The average age was52.37±9.18years old; The leftkidney tumor12cases,8cases right kidney tumors. Application of preciousstones energy spectrum CT and AW Volume Share5workstations, the image acquisition and analysis. Enhance contrast intravenous use Irich medicalbinocular high pressure syringe. Scan parameters: inside the tube voltage of0.5ms,140KVP and40instantaneous dual-energy KVP switching, usingautomatic tube technology to adjust current, to5mm, with a thick layer of layerspacing is5mm, reconstruction of an image layer thickness is0.625mm, layerspacing of0.625mm, pitch of0.984:1. Enhanced scanning methods:experimental group a total of120ml built300mgl/ml nonionic contrastmedium of iodine, inject the contrast agent is divided into two times, first timeat a rate of4.5ml/s injection of70ml, about15.5s; After the first injection of25s, the second injection contrast medium doses of50ml,40ml saline dose,the rate of4.5ml/s,20s; First note medicine began to start after70s thequantitative collection of CMP images. Scan range from adrenal area to renalpole. Scanning parameters: the tube voltage120kev, tube current is600mas,layer thickness is5mm,5mm layer spacing, reconstruction of an image layerthickness is0.625mm, layer spacing of0.625mm, pitch of0.984:1. Thecontrol of disposable injection built100ml300mgl/ml nonionic contrastmedium of iodine, injection rate is4.0ml/s. At the start of abdominal aortasetting watchpoints threshold selection for100(HU), to monitor the scanning,began to note the price comparison, after threshold automatically scan thequantitative collection of CMP images, CMP60s NP scan after scanning. Bytwo abdominal imaging diagnostic attending physician, independently of thetwo groups of cases to evaluate CT enhanced image.1. Measurement of renal tumor area and around essence area CT value;2. Measurement of renal vein CTvalue;3. Measure the tumor size, and renal fat clearance around it;4. Measureeach scanning DLP value;5. Calculation of renal tumor lesions, renalparenchyma and renal vein LKR, CNR, SNR, ED value;6. The subjectiveevaluation: display resolution analysis of the lesions.Results:1. Renal clear cell carcinoma patients with bilateral renal CTenhanced scan, from one period to the improved degree of quantitativeassessment (CT value): the experimental group of cortical phase (60kev)tumor CT value is lower than the control group on average, no statisticallysignificant difference between them (P=0.144); Experimental group of lateralrenal cortex average CT value is higher than the control group in the renalcortex period average CT value, no statistically significant difference (P=0.064). LKR close to0.7, controls LKR close to1.0, both difference isstatistically significant (P=0.000).2. The experimental group CNR slightlyhigher than the control group, the difference is not statistically significant (P=0.614). SNR value is slightly higher than the control group, the difference is notstatistically significant (P=0.538).3. The renal vein imaging analysis: theexperimental group and control group in cortex, renal vein average CT valuewere200.55±43.38HU and113.20±42.64HU, the difference has statisticalsignificance (P=0.000). Experimental VR as can be clearly showed renalarteries, renal vein trunk and main branches of anatomical structure of20cases(100%) and control group of18cases (80%), the two difference has significant statistical significance (P=0.000).4. Two groups of patients with subjectivescore analysis: the three points were3people,4points were17people, controlgroup3points2people,4points18people, difference is not statisticallydifference (P=0.609).5. Two groups of patients with radiation dose contrastanalysis: the experimental group of cases the average effective dose was7.25mSv, average effective dose cases of control group was15.64mSv, comparedwith control group, experimental group effective dose of drop of46%.6. Twogroups of patients with contrast agents of iodine intake and comparativeanalysis, the experimental group average intake dose is120ml, dose of1.8ml/kg on average.Conclusion:1. The energy spectrum CT adult single period injectionenhancement CT scanning of renal clear cell cancer shows good oven.2. Theenergy spectrum CT adult single period injection enhancement CT scanning forrenal vein display good, is better than that of single injection of dual phasescanning, for renal clear cell carcinoma preoperative clinical T stage, and thechoice of operation method has important clinical significance.3. The energyspectrum CT adult single period injection enhancement CT scanning greatlyreduce the radiation dose in patients with a drop of46%. |
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