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The first part of the dual-energy CT for the diagnosis of kidney cancer clinical applications: Virtual unenhanced image evaluation purposes: qualitative and quantitative comparison of the same patient obtained from dual energy CT virtual unenhanced images (virtual nonenhanced, VNE) and its practical unenhanced images ( true nonenhanced, TNE) data sets, and calculates pair of dual-energy mode scans compare three (including the actual scan) renal scan standard amount of radiation is poor. Materials and Methods: This prospective study has passed ethical review, all patients have also been signed informed consent. A total of 30 males, 5 females, mean age 58.75, range 31-82 years old, in the preoperative use of dual-energy CT scans carried out, including the unenhanced scans, skin medullary junction and tangible terms. DECT parameters for the A tube ball voltage 140kV, effective tube current 64mA, B tube ball voltage 80kV, effective tube current 272mA,. Renal parenchyma were measured and tumor, liver, aorta and lumbar major muscle CT values ??measured TNE and VNE image noise. 26cm field of view of the detector into the adjacent anatomical structures not covered by a 5 degree scoring system to evaluate (0 = none, 4 = gt; 75%), the division level artifacts and classification of virtual unenhanced images (virtual) VNE and TNE actual unenhanced images acceptability is also a hierarchy. DECT and TNE images calculated effective radiation dose, the difference by the t-test statistics. Results: TNE and VNE of the renal parenchyma, liver, aorta, psoas muscle and kidney tumor CT values ??were 26.26 ± 8.62 and 29.59 ± 7.28 (P = 0.130), 57.61 ± 6.36 and 54.24 ± 10.18 (P = 0.034) , 44.33 ± 4.99 and 40.78 ± 12.19 (P = 0.197), 46.30 ± 10.45 and 41.91 ± 7.71 (P = 0.520), 29.23 ± 10.45 and 26.06 ± 15.76 (P = 0.262); contralateral kidney did not pack into the range of the average grading 0.34 -0.64,26 patients without (0%), 6 cases of small (lt; 25%), 3 patients with mild (25-50%), 0 cases of moderate (50-75%), 0 cases of severe (gt ; 75%), the average image noise VNE, TNE were 7.37 ± 2.07 and 15.50 ± 5.26HU., dual-energy scanning peace sweep (single tube) mean effective doses were 5.94 ± 2.5 mSv and 3.51 ± 1.28mSv, eliminating the need for unenhanced radiation dose can be reduced to approximately 35%. Conclusion: In patients with renal tumors, dual-energy CT (dual-energy CT, DECT) can provide high-quality VNE data sets, it can serve as a reasonable estimate of TNE data sets. The dual-energy scanning combined with renal tumors scanning practices can reduce the radiation amounted to 35%. The second part of the multi-phase dual-energy CT scan for kidney cancer diagnosis and differential diagnosis of renal cell carcinoma histological subtypes Objective: This study will be multi-phase dual-energy CT scanning to evaluate the diagnostic value of renal cell carcinoma, and to explore dual-energy CT multi-phase scanning performance and the relationship between pathology Methods: A retrospective analysis of September 2008 to February 2010 period and dual-energy CT examination of 35 cases of pathologically confirmed renal cell carcinoma, measuring the size of the lesion, the junction of the skin and pith parenchymal phase region of interest (ROC, region of interest) CT value, assess the extent and ways to strengthen the lesion, and clear cell carcinoma and non-clear cell carcinoma lesions two degree of enhancement and enhancement pattern (homogeneous and heterogeneous enhancement enhancement ) for statistical analysis, the different scanning CT values ??of the differences with the statistical analysis. Results: clear cell carcinoma and non-clear cell carcinoma medullary junction of the two groups in the skin and substance of the CT values ??were 30.96 ± 40.01HU and 65.12 ± 15.72HU (P = 0.001), 97.07 ± 19.28HU and 59.12 ± 11.55HU ( P = 0.000), compared with non-clear cell carcinoma of clear cell carcinoma is more common heterogeneous enhancement (P lt; 0.05), different scanning phase CT values ??were significantly different (P = 0.000) Conclusion: CT values ??and the degree of enhancement and differences in the way for the identification of subtypes of RCC have important significance, dual energy CT low tube voltage (80kVp) image and the iodine distribution image can provide more information about the enhanced tumor intuitive. The third part of the kidney capsule of dual-energy CT showed localized resectable evaluation and kidney Objective: To evaluate dual-source CT in the dual-energy mode, multi-phase scanning in preoperative staging of diagnostic accuracy. Methods: A retrospective analysis from September 2008 to February 2010 by dual-energy CT examination room and pathologically confirmed 35 cases of renal cell carcinoma, renal cell carcinoma blinded by staging and determine whether to display the capsular lesions and The staging of the display of the results and enveloped the results were compared with pathological analysis, multi-phase dual-energy CT scanning for staging of renal diagnostic accuracy and that the situation on the envelope. Results: Dual-energy CT more accurate staging of kidney cancer were duration 100%, Ⅱ of 78%, Ⅲ of 100%, Ⅳ of 100%, the overall compliance rate was 94%, Ⅰ period and specificity were 100% and 88.3%, Ⅱ degree of sensitivity and specificity were 81.8% and 100%. Coated display rate of 80%. Conclusion: Dual-energy CT multi-phase scanning for staging of renal cell carcinoma has a high accuracy rate, and for the renal capsule and perirenal fat invasion of the display has certain advantages.
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