能谱CT成像诊断肾透明细胞癌术前分级的准确性研究  

Research on accuracy of energy spectrum CT imaging in diagnosis of preoperative grading of renal clear cell carcinoma

作　　者：叶亚君[1] 莫淑琼[1] YE Yajun;MO Shuqiong(The First People’s Hospital of Foshan, Guangdong, Foshan 528000, China)

机构地区：[1]广东省佛山市第一人民医院

出　　处：《中国医药科学》2019年第11期104-107,共4页China Medicine And Pharmacy

摘　　要：目的探讨能谱CT成像诊断肾透明细胞癌术前分级的准确性。方法回顾性分析我院2017年1月~2018年9月100例经病理组织学诊断为肾透明细胞癌患者能谱CT成像双期扫描资料,以病理结果为金标准,分析能谱CT成像肾透明细胞癌术前分级诊断结果。结果不同病理分级动脉期与髓质期能谱参数CT值比值、碘浓度比值、能谱曲线斜率结果比较,均为Ⅰ级>Ⅱ级>Ⅲ级(P <0.05);以患者动脉期与髓质期能谱参数为变量,患者肾透明细胞癌级别为状态量,绘制ROC曲线,病理分级Ⅰ、Ⅱ级诊断中,动脉期能谱曲线斜率AUC=0.952,高于动脉脉期CT值比值AUC=0.752、碘浓度比值AUC=0.855以及髓质期CT值比值AUC=0.898、碘浓度比值AUC=0.829、能谱曲线斜率AUC=0.786,差异有统计学意义(P <0.05);病理分级Ⅱ、Ⅲ级诊断中髓质期能谱曲线斜率AUC=0.993,高于动脉期能谱曲线斜率AUC=0.888,CT值比值AUC=0.811、碘浓度比值AUC=0.821以及髓质期CT值比值AUC=0.810、碘浓度比值AUC=0.895,差异有统计学意义(P <0.05)。结论能谱CT成像对于术前肾透明细胞癌术前分级诊断有重要的临床价值。Objective To explore the accuracy of energy spectrum CT imaging in the diagnosis of preoperative grading of renal clear cell carcinoma. Methods The dual-phase scanning data of energy spectrum CT imaging of 100 patients who were diagnosed as renal clear cell carcinoma by histopathology in our hospital from January 2017 to September 2018 were retrospectively analyzed. The pathological results were taken as the gold standard, and the diagnostic results of preoperative grading of renal clear cell carcinoma were analyzed by energy spectrum CT imaging. Results CT value ratio of energy spectrum parameters, iodine concentration ratio and slope of energy spectrum curve of arterial phase and medullary phase in different pathological grades showed that those of grade I were more than those of grade II, followed by grade III. The difference was statistically significant(P < 0.05). ROC curve was drawn by taking the energy spectrum parameters of patients in the arterial and medullary phase as variables and the grade of patients with renal clear cell carcinoma as status quantity. In the pathological grade I and II diagnosis, the slope of energy spectrum curve AUC in the arterial phase was 0.952, higher than the CT value ratio AUC(0.752) andthe ratio of iodine concentration AUC was 0.855. CT value ratio AUC in the medullary phase was 0.898, the iodine concentration ratio AUC was 0.829 and the slope of energy spectrum curve AUC was 0.786.The difference was statistically significant(P < 0.05).In the pathological grade II and III diagnosis, the slope of energy spectrum curve AUC in the medullary phase was 0.993, higher than that in the arterial phase 0.888, CT value ratio AUC in the arterial phase 0.811, iodine concentration AUC in the arterial phase 0.821, CT value ratio AUC in the medullary phase 0.810 and iodine concentration AUC in the medullary phase 0.895. The differences were statistically significant(P < 0.05). Conclusion Energy spectrum CT imaging has important clinical values for diagnosis of preoperative grading of renal

关 键 词：能谱CT成像 肾透明细胞癌 术前分级 准确性 

分 类 号：R445.3[医药卫生—影像医学与核医学]