两种测量法最小CT值对肾上腺瘤体的鉴别诊断价值  

作　　者：朱妙平 瞿佳丽 韩志江[3] 

机构地区：[1]杭州市妇产科医院,310006 [2]杭州市富阳人民医院,311400 [3]杭州市第一人民医院放射科,310006

出　　处：《浙江临床医学》2013年第11期1615-1617,共3页Zhejiang Clinical Medical Journal

摘　　要：目的使用4点法和3层法评价平扫最小CT值在肾上腺瘤体鉴别诊断中的价值。方法回顾分析肾上腺瘤体123例（129枚），分别采用4点及3层测量法，测量各点最小CT值，分析不同阈值下两种方法的敏感度，特异度，阳性预测值，准确度，制作ROC曲线。结果肾上腺瘤体123例（129枚），包括51枚腺瘤，15枚髓样脂肪瘤和其他瘤体63枚（42枚转移瘤，14枚嗜铬细胞瘤，4枚淋巴瘤，3枚皮质癌）。4点法中，以平均最／小CT值≤0HU为阈值判断腺瘤（除外髓样脂肪瘤），敏感度、特异度、阳性预测值、准确度分别为90．2％、95．2％、93．9％、93．0％，ROC面积为0．961。3层法中，以平均最小值CT值≤-69．5HU为阈值判断髓样脂肪瘤，敏感度、特异度、阳性预测值、准确度分别为100％、96．1％、88．2％、97％，ROC面积为0．997。结论4点法平均最小CT值≤0HU和3层法中平均最小CT值≤．69．5HU分别对腺瘤与非腺瘤（除外髓样脂肪瘤）和腺瘤与髓样脂肪瘤的诊断具有指导作用，二者联合应用对于肾上腺瘤体的鉴别诊断具有重要价值。Objective To evaluate the value of the lowest mean attenuation measured with 4-point measurement and 3-slice measurements on plain CT in differential diagnosis of adrenal neoplasms. Methods 129 cases of adrenal lesions were enrolled into this study. All masses were measured with 4-point measurement and 3-slice measurement to get the lowest mean attenuation.The sensitivity, specificity, false positive rate and false negative rate, positive predictive value, negative predictive value, accuracy were analyzed on different thresholds, and ROC curves were made, Results The 129 cases of adrenal lesions included 51 cases of adenoma, 15 cases of medullary lipoma and other 63 cases （ including 42 patients with metastatic tumor, and 14 cases were pheochromocytoma, 4 cases of lymphoma, 3 cases of cortical carcinoma ） .Taking 0HU as the cutoff, the sensitivity, specific degree, positive predictive value and diagnostic accuracy were 90.2%, 95.2%, 93.9%, 93.0% by 4-point measurement to diagnose the mass that excluded medullary lipoma While they were100%, 96.1%, 88.2%, 97% by 3-slice measurement to judge medullary lipoma by the cutoffat -70HU.Meanwhile the ROC curves were 0.961 and 0.997. Conclusion It is more easy to different adenoma from adrenal mass with the 4-point measurement while medullary lipoma with 3-slice measurement.And there is significant value on adrenal-lesion-diagnosis by simultaneously apply the two method.

关 键 词：肾上腺瘤体 腺瘤 髓样脂肪瘤体层摄影术 X线计算机CT值 

分 类 号：R735.7[医药卫生—肿瘤]