双能量CT后处理单能谱模式有效识别肾周脂肪粘连及全息可视化三维成像研究-东南大学学报医学版

双能量CT后处理单能谱模式有效识别肾周脂肪粘连及全息可视化三维成像研究

单位：1. 东部战区总医院放射诊断科, 江苏南京 210002;
2. 中国医科大学附属盛京医院泌尿外科, 辽宁沈阳 110004;
3. 东部战区总医院泌尿外科, 江苏南京 210002

分类号：R814.42;R692

出版年·卷·期（页码）：2022·41·第五期（688-694）

摘要：

目的：采用双能量CT （DECT）后处理单能谱（Mono⁺）模式有效识别肾周脂肪粘连（APF）及研究全息可视化三维（V3D）成像对APF区域的显示作用。方法：前瞻性收集东部战区总医院泌尿外科于2020年2月至2021年12月间拟行保留肾单位手术（NSS）的T1期（RENAL评分≥7分）肾癌患者60例，随机分为V3D组（组A，n=30）和CT图像组（组B，n=30例），所有患者术前均行DECT肾脏三期动态增强扫描，并将组A生成的DICOM格式文件传至DECT后处理工作站，选取Mono⁺模式对肾周脂肪情况进行识别，分析结束后将数据导入至全息V3D重建软件，进行V3D建模及结果发布；组B进行常规CT薄层图像重建，并以传统胶片的形式进行结果发布。对两组患者的一般人口学特征、围手术期结果进行比较。结果：两组患者的一般人口学特征未见明显差别；采用DECT后处理Mono⁺模式可有效识别APF，并通过V3D技术对APF区域进行显示；组A在成功实施NSS例数上明显多于组B （P<0.05），组A的手术时间、热缺血时间及估计失血量均少于组B （均P<0.05）。结论：基于DECT后处理Mono⁺模式功能可有效预测APF的发生，并采用V3D技术对APF区域进行打印，可显著提高肾癌行NSS的成功率，缩短手术时间、热缺血时间及减少估计失血量。

Objective: To effectively identify adherent perinephric fat (APF) by dual energy CT (DECT) post-processing single energy spectrum (Mono⁺) mode and study holographic visual three-dimensional (V3D) imaging. Methods: Sixty patients with stage T1 renal cell carcinoma (RENAL score ≥ 7) who were underwent nephron sparing surgery (NSS) in the hospital from February 2020 to December 2021 were prospectively collected and randomly divided into V3D group (group A, n=30) and CT image group (group B, n=30). All patients underwent three-phase dynamic contrast-enhanced scanning of DECT for kidney before operation, and the DICOM format file generated in group A was transmitted to DECT post-processing workstation. Mono⁺ mode was selected to identify the APF. After the analysis, the data were imported into the holographic V3D reconstruction software for 3D modeling and imaging. Group B received conventional thin-layer CT image, and the results were released in the traditional CT film mode. The general demographic characteristics and perioperative results of the two groups were compared. Results: There was no significant difference in general demographic characteristics between the two groups; Mono⁺ could effectively identify APF and underwent V3D imaging. The number of successful implementation of NSS in group A was significantly more than that in group B (P<0.05), and the operation time, blood loss time and estimated blood loss in group A were less than those in group B (all P<0.05). Conclusion: Mono⁺mode function based on DECT post-processing can effectively predict the occurrence of APF, and the V3D imaging of APF can significantly improve the success rate of NSS and the perioperative indexes.

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