目的 探讨第三代双源CT能谱纯化技术在鼻窦CT中的可行性.方法 前瞻性选取44例行鼻窦CT扫描的患者,用随机数字表法分为低剂量组和能谱纯化组,每组22例,2组的管电压和管电流分别为100 kVp、80 mAs(低剂量组)和Sn100 kVp、300 mAs(能谱纯化组).测量2组患者图像的玻璃体、眶脂体和皮肤外空气CT值、噪声,记录设备显示的辐射剂量数值,并计算对比噪声比(CNR)和有效剂量品质因子(FOM).组间各部位的CT值、噪声、CNR、FOM和辐射剂量的差异用独立样本t检验进行比较,组间图像质量主观评分差异用非参数Wilcoxon符号秩和检验比较.结果 组间图像质量主观评分、玻璃体噪声、空气CT值、空气噪声、玻璃体-空气CNR差异均无统计学意义(P值均>0.05).组间玻璃体CT值(29.27 HU±6.56 HU vs 24.81 HU±6.04 HU,P=0.024)、眶脂体CT值(-106.00 HU±12.95 HU vs-98.05 HU±9.21 HU,P=0.024)、眶脂体噪声(13.41±3.30 vs 15.77±2.78,P=0.014)、玻璃体-眶脂体CNR(10.09±2.31 vs 8.41±2.09,P=0.015)、玻璃体-空气FOM(19403.75±6579.46 vs 42603.89±18014.61,P<0.01)、玻璃体-眶脂体FOM(334.44±157.37 vs 622.89±321.20,P<0.01)及辐射剂量的差异均有统计学意义.结论 第三代双源CT能谱纯化技术在鼻窦CT可获得满意的图像质量,同时大幅降低了辐射剂量.

Objective:To compare the short-term efficacy and safety between 1 470 nm diode laser enucleation of the prostate (DiLEP) and plasmakinetic enucleation of the prostate (PKEP) in treating benign prostatic hyperplasia (BPH).Method:From August 2016 to July 2017,a total of 180 consecutive BPH patients with lower urinary tract obstruction were randomly assigned to either 1 470 nm DiLEP group (n=90) or PKEP group (n=90)respectively in our institution.All patients enrolled in the present study have been evaluated preoperatively and followed-up at 1 and 3 months postoperatively.Preoperative characteristics,intraoperative data and postoperative outcomes of all patients were recorded and compared.Result:There was no statistical difference in the preoperative characteristics between the DiLEP and PKEP group (P＞0.05).Compared with PKEP,the DiLEP group had significantly shorter operative time,postoperative bladder irrigation time,postoperative catheterization time and less drop in postoperative serum hemoglobin and sodium levels (all P＜0.001).No severe intraoperative complications such as bladder perforation,excessive haemorrhage or transurethral resection syndrome occurred.DiLEP group was equivalent to PKEP group in International Prostate Symptom Score,quality of life scores,Qmax and post-voiding residual volume before and after surgery (all P＞0.05).The overall follow-up period ranged from 3-14 months,and the mean follow-up period (mean±SD) was (7.2±2.4) months.During the follow-up period,no incontinence or urethral stricture was observed in the DiLEP group.Only one patient had hematuresis one week after surgery and was cured by symptomatic treatment.Whereas,two patients (2.2％) suffered from incontinence in PKEP group.Conclusion:The present study verified the advantages of 1 470 nm DiLEP in treating patients with symptomatic BPH,as the efficacy of DiLEP and PKEP were similar while the former technique provides less risk of perioperative complications,shorter operative time and reduced bladder irrigation and catheterization time.