能谱CT鉴别诊断腮腺良恶性肿瘤  

Spectral CT imaging in diagnosis of benign and malignant parotid tumors

作　　者：靳晓媛[1] 刘斌[1] 李红文[1] 吴兴旺[1] 汪洁[1] 

机构地区：[1]安徽医科大学第一附属医院放射科,安徽合肥230022

出　　处：《中国医学影像技术》2015年第3期367-371,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨能谱CT多参数成像技术对临床常见的腮腺肿瘤的鉴别诊断价值。方法收集经手术病理证实的62例腮腺肿瘤患者,其中良性肿瘤50例,恶性肿瘤12例,所有患者术前均接受颈部能谱CT扫描。采用GSI Viewer软件获取病变组织碘浓度值、能谱曲线斜率、有效原子序数。应用Wilcoxon秩和检验进行统计学处理。绘制ROC曲线,得出最佳诊断阈值及诊断的敏感度和特异度。结果平扫期碘浓度、曲线斜率、有效原子序数的中位数(上、下四分位数),腮腺良性肿瘤分别为-1.41×100μg/ml(-2.25×100μg/ml,0.16×100μg/ml)、-0.10(-0.31,0.12)、7.25(7.17,7.40),腮腺恶性肿瘤分别为-1.13×100μg/ml(-1.46×100μg/ml,1.44×100μg/ml)、1.01(-0.19,2.04)、7.17(7.13,7.48),两组间差异均无统计学意义(P均>0.05)。动脉期碘浓度、曲线斜率、有效原子序数的中位数及上、下四分位数,腮腺良性肿瘤分别为9.65×100μg/ml(4.29×100μg/ml,18.37×100μg/ml)、0.69(0.31,1.59)、7.89(7.71,9.15);腮腺恶性肿瘤分别为18.04×100μg/ml(12.5×100μg/ml,20.98×100μg/ml)、1.56(1.29,2.65)、9.22(9.11,9.28),两组间差异有统计学意义(Z值分别为-3.273、-2.43、-3.01,P均<0.05);静脉期各参数差异均无统计学意义(P均>0.05)。以动脉期碘浓度>18.90μg/ml、曲线斜率>1.247、有效原子序数>9.05为阈值诊断腮腺恶性肿瘤的敏感度分别为91.7%、75.0%、91.7%,特异度分别为79.5%、71.8%、82.1%。结论能谱CT增强扫描动脉期多参数成像对腮腺良恶性肿瘤的鉴别诊断具有一定价值。Objective To investigate the value of gemstone spectral imaging（GSI）in diagnosis of benign and malignant parotid tumors.Methods Totally of 62 patients with parotid tumors confirmed by surgery and pathology,including 50 with benign tumors and 12 with malignant tumors were enrolled.All the patients examined with spectral CT scanning.Iodine concentration,slope of spectral curve,effective-Z were obtained by using GSI Viewer software.Wilcoxon rank sum test were used to analyze the differences of parameters between the benign and malignant parotid tumors.ROC curve was drawn to get the best diagnostic threshold and diagnostic sensitivity and specificity.Results In non-contrast CT imaging,the median and quartile range of iodine concentration,slope of spectral curve,effective-Z were-1.41×100μg/ml（-2.25×100μg/ml,0.16×100μg/ml）,-0.10（-0.31,0.12）,7.25（7.17,7.40）in benign tumors,-1.13×100μg/ml（-1.46×100μg/ml,1.44×100μg/ml）,1.01（-0.19,2.04）,7.17（7.13,7.48）in malignant tumors.There were no significant difference（all P〉0.05）.In the arterial phase,the median and quartile range of iodine concentration,slope of spectral curve effective-Z were 9.65×100μg/ml（4.29×100μg/ml,18.37×100μg/ml）,0.69（0.31,1.59）,7.89（7.71,9.15）in benign tumors,18.04×100μg/ml（12.50×100μg/ml,20.98×100μg/ml）,1.56（1.29,2.65）,9.22（9.11,9.28）in malignant tumors（Zvalue were-3.273,-2.43,-3.01,respectively,all P〉 0.05）.In venous phase,no significant difference were found for each parameter between the two groups（all P〉0.05）.In the arterial phase,taking iodine concentration〉18.90μg/ml,slope of spectral curve〉1.247,effective-Z〉9.05 as threshold to predict malignancy,the sensitivity and specificity were 91.7%,75.0%,91.7% and 79.5%,71.8%,82.1%,respectively.Conclusion Spectral CT imaging have a potential value in differential diagnosis of benign and malignant parotid tumors.

关 键 词：体层摄影术 X线计算机 能谱成像 腮腺疾病 诊断 

分 类 号：R781.7[医药卫生—口腔医学] R814.42[医药卫生—临床医学]