双能量CT碘图定量参数在鉴别声带良恶性病变中的价值  

The value of dual-energy CT iodine maps parameters in differentiating benign from malignant vocal cord lesions

作　　者：瞿姣 危春容 吴莉[1] 赵卫[1] 王元玲[1] 杨亚英[1] QU Jiao;WEI Chunrong;WU Li;ZHAO Wei;WANG Yuanling;YANG Yaying(Department of Medical Imaging,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院医学影像科,昆明650032

出　　处：《实用医学杂志》2019年第21期3366-3369,3373,共5页The Journal of Practical Medicine

基　　金：云南省应用基础研究(昆医联合专项)项目[编号：2017FE467(-052)]

摘　　要：目的探讨双能量CT动脉期碘图定量参数在鉴别声带良恶性病变中的价值。方法收集具有完整双能量CT扫描资料并经病理证实的声带病变患者128例,按病理类型分为声带鳞癌组(50例)、声带息肉组(50例)及声带慢性炎组(28例),比较3组病变动脉期碘图定量参数(碘浓度、标准化碘浓度及Overlay值)的差异。将128例病变分为良性组(78例)及恶性组(50例),绘制ROC曲线并计算曲线下面积及最佳诊断阈值以分析各参数鉴别声带良恶性病变的效能。结果声带鳞癌动脉期碘浓度、标准化碘浓度及Overlay值均高于声带慢性炎及声带息肉(P<0.05);动脉期碘浓度、标准化碘浓度及Overlay值鉴别声带良恶性病变的ROC曲线下面积分别为0.933、0.845及0.868(P<0.001),以碘浓度1.75 mg/mL为临界值诊断声带鳞癌的敏感度及特异度分别为98%及83.3%,以标准化碘浓度0.16为阈值诊断声带鳞癌的敏感度及特异度分别为84%及76.9%,以Overlay值40.15 HU为临界值诊断声带鳞癌的敏感度及特异度分别为78%及91%。结论双能量CT动脉期碘图相关参数在声带良恶性病变的鉴别中具有一定价值。Objective To investigate the value of dual?energy CT(DECT)quantitative parameters in the differential diagnosis of benign and malignant vocal cord lesions.Methods This study enrolled 128 patients with vocal cord lesions[including 50 cases of squamous cell carcinoma(SCC),50 cases of polyp and 28 cases of chronic inflammation]had complete DECT data.The DECT iodine enhancement metrics[iodine concentration(IC),normalized iodine concentration(NIC)and Overlay value]in arterial phase of the three groups were compared.Then,128 cases were divided into the benign group(78 cases)and the malignant group(50 cases).ROC curve analysis was performed and the area under the curve(AUC)and the optimal diagnostic threshold were calculated to analyze the efficacy of each parameter in the detecting of SCC.Results The IC,NIC and Overlay value in the vocal cord SCC group were higher than those in the chronic inflammation group and the polyp group(P<0.05).The AUCs of IC,NIC and Overlay value in diagnosing SCC were 0.933,0.845 and 0.868,respectively(P<0.001).Taking IC 1.75 mg/mL as cutoff value,the sensitivity was 98%and the specificity was 83.3%,respectively.Taking NIC=0.16 as a critical value,the sensitivity was 84%and the specificity was 76.9%,respectively.While the sensitivity and specificity were 78%and 91%with Overlay value=40.15 HU as cutoff value.Conclusion The quantitative parameters of DECT iodine map in artery phase own certain value in the differential diagnosis of benign and malignant vocal cord lesions.

关 键 词：声带息肉 喉癌 双能量 体层摄影术 X线计算机 碘分布伪彩图 碘浓度 

分 类 号：R73[医药卫生—肿瘤]