CT能谱成像在鉴别卵巢良恶性肿瘤中的作用  

Value of spectral CT imaging in the differential diagnosis of benign and malignant ovarian tumors

作　　者：郭丹丹[1] 张智栩[1] 侯平[1] 柴亚如 李佳音[1] 刘洋[1] 高剑波[1] GUO Dandan,ZHANG Zhixu,HOU Ping,CHAI Yaru,LI Jiayin,LIU Yang,GAO Jianbo(Department of Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052, China)

机构地区：[1]郑州大学第一附属医院放射科,河南郑州450052

出　　处：《实用放射学杂志》2018年第3期398-400,451,共4页Journal of Practical Radiology

摘　　要：目的 探讨CT能谱成像定量分析在鉴别卵巢良恶性肿瘤中的应用价值。方法 收集经手术病理证实且术前均行双期GSI能谱扫描的34例卵巢肿瘤患者，其中卵巢良性肿瘤11例，恶性肿瘤23例；所有图像重建后经GSI viewer软件分别测量双期肿瘤实性成分的CT值、碘浓度及能谱曲线，并计算病变双期的标准化碘浓度（标准化碘浓度=病灶的碘浓度/同层髂动脉碘浓度）和能谱曲线斜率［斜率=（HU 40 keV-HU 100 keV）/60］；采用独立样本t检验对卵巢良恶性肿瘤参数进行统计学比较，并绘制受试者工作特征曲线（ROC曲线）评估相应参数的诊断效能。结果 卵巢恶性肿瘤能谱曲线斜率、碘浓度、标准化碘浓度在静脉期分别为1.72±0.77、14.50±6.44（100 μg/cm3）、0.33±0.12；卵巢良性肿瘤能谱曲线斜率、碘浓度、标准化碘浓度在静脉期分别为1.05±0.48、8.86±4.04（100 μg/cm3）、0.22±0.13；卵巢恶性肿瘤组仅在静脉期的能谱曲线斜率、碘浓度、标准化碘浓度高于卵巢良性肿瘤组（P均=0.01），而卵巢良恶性肿瘤之间CT值差异无统计学意义（P＞0.05）。结论 卵巢良恶性肿瘤实性成分的能谱CT参数有显著差异。CT能谱成像可以为卵巢良恶性肿瘤的鉴别诊断提供更多的信息，具有一定的临床应用价值。Objective To investigate the CT spectral imaging features of benign and malignant ovarian tumors and to assess the value of spectral CT in differentiating between benign and malignant ovarian tumors.Methods This study was granted by the institutional review board with a waiver for informed consent.34 patients with ovarian tumor （11 benign tumors and 23 malignant tumors） underwent preoperative CT scanning that included arterial phase （AP） and venous phase （VP） with GSI mode. Measurements were performed on the GSI viewer. The iodine concentration （IC, 100 ug/cm^3） was saved, and the normalized iodine concentration （NIC） and the spectral curve （spectral Hounsfield unit curve） were recorded. The slope of the curve was calculated as the formula： （CT attenuation （40 keV）-CT attenuation （100 keV） ）/60.The CT value was measured at 70 keV in Mono image.CT values,the slope of the spectral curve, the iodine concentration and NIC were compared between the two groups by using independent sample t-test with software SPSS 21.0. Receiver operating characteristic （ROC） was used to determine the threshold of slope of the spectral curve, the iodine concentration and NIC for differentiating benign and malignant ovarian tumors in VP.Resuits The slope of the spectral curve,the iodine concentration and NIC of malignant ovarian tumors in VP were 1.72±0.77, 14.50±6.44 （ 100μg/cm^3 ）, and 0.33±0.12. The slope of the spectral curve, the iodine concentration and NIC of benign ovarian tumors in VP were 1.05±0.48,8.86±4.04 （100 μg/cm^3） ,and 0.22±0.13.Significant differences were found between the slope of spectral curve, the iodine concentration and NIC of the malignant ovarian tumors and those of the benign ovarian tumors in VP （P =0.01 ）. CT values in double phases revealed no difference between these two groups （P〉0.05）.Conclusion There is a significant difference between the solid component of benign ovarian tumors and that of malignant ovarian tumors in spectral CT. GSI

关 键 词：卵巢肿瘤 计算机体层成像 

分 类 号：R737.31[医药卫生—肿瘤] R814.42[医药卫生—临床医学]