ldtЛучевая диагностика и терапияDiagnostic radiology and radiotherapy2079-5343Baltic Medical Education Center10.22328/2079-5343-2018-4-13-20ldt-337Research ArticleЛЕКЦИИ,ОБЗОРЫВОЗМОЖНОСТИ ДВУХЭНЕРГЕТИЧЕСКОЙ КОМПЬЮТЕРНОЙ ТОМОГРАФИИ В ДИФФЕРЕНЦИАЛЬНОЙ ДИАГНОСТИКЕ ОЧАГОВЫХ ОБРАЗОВАНИЙ ПЕЧЕНИPOSSIBILITIES OF DUALENERGY COMPUTED TOMOGRAPHY IN THE DIFFERENTIAL DIAGNOSIS OF FOCAL LESIONS OF THE LIVERСавельеваА. С.SavelevaA. S.

ассистент кафедры лучевой диагностики ИПО;

врач-рентгенолог рентгенологического отделения,

660022, г. Красноярск, ул. Партизана Железняка, д. 1

Krasnoyarsk

КарловаЕ. А.KarlovaE. A.

кандидат медицинских наук, доцент кафедры лучевой диагностики;

врач-рентгенолог рентгенологического отделения,

660022, г. Красноярск, ул. Партизана Железняка, д. 1

Krasnoyarsk

elenakarlova67@gmail.comПротопоповА. В.ProtopopovA. V.

доктор медицинских наук, заведующий кафедрой лучевой диагностики ИПО,

660022, г. Красноярск, ул. Партизана Железняка, д. 1

Krasnoyarsk

МеркуловаН. А.MerkulovaN. A.

заведующая рентгенологическим отделением,

660113, г. Красноярск, 1-я Смоленская ул., д. 16

Krasnoyarsk

ТяжельниковаЗ. М.TyazhelnikovaZ. M.

кандидат медицинских наук, доцент кафедры лучевой диагностики ИПО,

660022, г. Красноярск, ул. Партизана Железняка, д. 1

Krasnoyarsk

Красноярский государственный медицинский университет им. профессора В. Ф. Войно-Ясенецкого; Красноярский краевой клинический онкологический диспансер им. А. И. КрыжановскогоРоссияProf. V. F. Voino-Yasenetsky Krasnoyarsk State Medical University; A. I. Kryzhanovsky Krasnoyarsk Regional Clinical Oncological CentreRussian FederationКрасноярский государственный медицинский университет им. профессора В. Ф. Войно-ЯсенецкогоРоссияProf. V. F. Voino-Yasenetsky Krasnoyarsk State Medical UniversityRussian FederationКрасноярский краевой клинический онкологический диспансер им. А. И. КрыжановскогоРоссияA. I. Kryzhanovsky Krasnoyarsk Regional Clinical Oncological CentreRussian Federation201829012019041320Copyright © Савельева А.С., Карлова Е.А., Протопопов А.В., Меркулова Н.А., Тяжельникова З.М., 20192019Савельева А.С., Карлова Е.А., Протопопов А.В., Меркулова Н.А., Тяжельникова З.М.Saveleva A.S., Karlova E.A., Protopopov A.V., Merkulova N.A., Tyazhelnikova Z.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://radiag.bmoc-spb.ru/jour/article/view/337

Своевременная и точная диагностика очагового поражения печени, несмотря на имеющийся арсенал модальностей лучевого обследования, до сих пор остается сложной задачей. Особую трудность представляют очаги малого диаметра, атипичный характер контрастирования; сочетание множественных образований различного генеза; очаги на фоне диффузных изменений печени; поражения печени, имитирующие новообразования. Метод двухэнергетической компьютерной томографии дает новые алгоритмы анализа, отличные от традиционной КТ. В статье представлен обзор литературы, посвященной использованию качественных и количественных параметров спектрального сканирования в  разные фазы контрастного усиления в  дифференциальной диагностике очаговых образований печени. Использование низкоэнергетических монохроматических изображений и количественный анализ содержания йода способствуют лучшей визуализации очагов печени и большей уверенности в их дифференциальной диагностике.

Timely and accurate diagnosis of focal lesions of the liver, despite the existing arsenal of of radiation examination modalities, still remains a challenge. Particular difficulty is caused by foci of small diameter, an atypical character of contrasting; a combination of multiple formations of different genesis; focus against the background of diffuse liver damage; liver damage, mimicking tumors. DECT method givesnew analysis algorithms that are different from traditional CT. The article presents a review of the literature on the use of qualitative and quantitative parameters of spectral scanning in different phases of contrast enhancement in the differential diagnosis of liver focal lesions. The use of low-energy monochromatic images and the quantitative analysis of iodine content contribute to a better detection of liver foci and greater confidence in differential diagnosis.

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The authors declare that there are no conflicts of interest present.