文伟,徐丽艳,赵震奇
WEN Wei1,XU Liyan2,ZHAO Zhenqi1(1.Department of Radiology

• 1:贵阳医学院附院放射科
• 2:安徽医科大学第一附属医院放射科
• 3:贵阳医学院附院放射科 贵州贵阳550004
• 4:安徽合肥230000

摘要(Abstract)：

目的:研究螺旋CT仿真膀胱镜(CTVC)成像过程中应注意的技术性问题。方法:取5只离体猪膀胱,在其黏膜面制造直径5 mm左右的结节,充盈气体后进行CT扫描,采用层厚1 mm、3 mm及5 mm,螺距1.0、1.3及1.5,以重建重叠率分别为0及50%进行重建,并分别匹配分为11组。计算各组的检出率。利用SPSS13.0统计学软件,对层厚、螺距及重建重叠率进行三因素分析。结果:(1)第1组(层厚1.0 mm,螺距1.0)检出的准确率最高,但与第2、3、4、5、6组之间的差异无统计学意义(P>0.05);与第7、8、9、10组之间的差异有统计学意义(P<0.05)。(2)三因素析因分析结果显示,层厚因素对检出率有显著影响(P<0.01),螺距因素对检出率有显著影响(P<0.05),重建重叠率对检出率无显著影响(P>0.05)。结论:(1)层厚和螺距是影响CTVC成像的主要因素。(2)在CTVC成像过程中源图像的质量、不同的透视图算法、阈值和视角的选择、膀胱内存在的少量液体及一些内在和外在的假象均是影响图像质量的主要因素。
Objective: To study the techniques in virtual cystoscopy with computed tomography(CTVC).Methods: Five ex vivo pig bladders were selected and cleaned,and simulated polyps were created on the mucosa of them.Each specimen was scanned as slices of 1.0mm,3.0mm,5.0mm in width and of 1.0,1.3,1.5 pitch,and was reconstructed with 0 and 50% overlap,respectively except the slice with width of 1.0mm and the pitch of 1.0.The images were classified into 11 groups according to different parameters(width,pitch,and reconstruction width).Disease detecting rate of each group was compared and the influence of the three factors was analyzed with statistics software of SPSS 13.0.Results: 1.Group 1(slice width 1.0mm,pitch 1.0) had the maximal accuracy of nodus detection,and there was no significant difference among groups 2-6(P>0.05);but there were significant differences among groups 7-11(P<0.05).2.The factor analysis showed that the pitch,slice width had statistical significance(P<0.05),while the reconstruction width did not(P>0.05).Conclusions: 1.There are many influential factors in CTVC,and slice width and pitch are the two major influential factors;2.The quality of the source images,different rendering algorithms,selection of threshold values and optic angles,fluid in the bladder,and some artifacts,etc.are some other factors influencing quality of CTVC images.The operator should work with graveness in imaging of CTVC,since they are important complementary evidence for the accurate diagnosis of bladder tumor.

关键词(KeyWords)： 膀胱肿瘤;体层摄影术,螺旋计算机;膀胱镜检查;成像,三维
bladder neoplasms;tomography,spiral computed;cystoscopy;imaging,three-dimensional

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 文伟,徐丽艳,赵震奇
WEN Wei1,XU Liyan2,ZHAO Zhenqi1(1.Department of Radiology

DOI: 10.19367/j.cnki.1000-2707.2007.02.018

参考文献(References)：

• [1]Vining DJ,Zagoria RJ,Liu K,et al.CTcystoscopy:an in-novation in bladder imaging[J].Am J Roentgenol,1996(166):409-410.
• [2]Narumi Y,Kumatani T,Sawai Y,et al.The bladder andbladder tumours:imaging with three-dimensional displayof helical CT data[J].Am J Roentgenol,1996,(167):1134-1135.
• [3]Fenlon HM,Bell TV,Ahari HK,Virtual cystoscopy:earlyclinical experience[J].Radiology,1997(205):272-275.
• [4]Bernhardt TM,Rapp-Bernhardt U.Virtual cystoscopyof the bladder based on CTand MRI data[J].Abdom Im-aging,2001(3):325-332.
• [5]Merkle EM,Wunderlich A,Aschoff AF,et al.Virtualcystoscopy based on helical CTscan datasets:perspectivesand limitations[J].Br J Radiol,1998(71):262-267.
• [6]Hussain S,Loeffler JA,Babayan RK,et al.Thin-sec-tion helical computed tomography of the bladder:initialclinical experience with virtual reality imaging[J].Urolo-gy 1997(50):685-688.
• [7]Cisel Yazgan,Suat Fitoz,Cetin Atasoy,et al.Virtual cys-toscopy in the evaluation of bladder tumors[J].J Clin Im-aging,2004(28):138-142.
• [8]杨秀军,陈峰,韩萍,等.临床仿真影像学[M].北京:人民卫生出版社,2002:53-58.
• [9]李志坚,张学斌,唐秉航,等.多层面螺旋CT仿真膀胱镜对膀胱肿瘤的诊断价值[J].临床泌尿外科杂志,2003(18):399-401.

文章评论(Comment)：