能谱CT增强扫描物质分离技术在小肝癌术前定量评估中的应用  

Application of Enhanced Spectral CT Material Decomposition Technique in Preoperative Quantitative Evaluation of Small Hepatocellular Carcinoma

作　　者：冯坤鹏[1] 孙冰 FENG Kun-peng;Sun Bing(Imaging Center,Shangqiu First People's Hospital,Shangqiu 476000,Henan Province,China)

机构地区：[1]河南省商丘市第一人民医院影像中心,河南商丘476000

出　　处：《中国CT和MRI杂志》2020年第8期90-92,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨能谱电子计算机断层扫描(CT)增强扫描物质分离技术在小肝癌术前定量评估中的应用价值。方法纳入2016年1月~2018年6月间收治的56例临床怀疑小肝癌患者为研究对象,所有患者均经CT能谱模式扫描。以病理检查为金标准,比较能谱CT多期肝癌标准碘基值(NIC)、标准水基值(NWC),分析能谱CT对肿瘤微血管侵犯的诊断效能。结果①能谱CT诊断小肝癌灵敏度、特异度、准确率及阳性阴性预测值分别为93.48%、80.00%、91.07%、95.56%、72.73%,ROC曲线下面积分别为0.867;②微血管侵犯病灶动脉期NIC高于无微血管侵犯者(P<0.05);微血管侵犯与无微血管侵犯的门脉期NIC、动脉期NWC、门脉期NWC对比,差异均无统计学意义(P>0.05);③ROC曲线结果显示,NIC诊断小肝癌微血管侵犯的临界值为0.135,AUC为0.881,敏感度0.784,特异度0.8,约登指数0.584。结论能谱CT物质分离技术可用于小肝癌的定量诊断,碘基值有助于反映微血管侵犯。Objective To explore the application value of spectrum computed tomography(CT)enhanced scanning quantification in the preoperative quantitative evaluation of small hepatocellular carcinoma.Methods A total of 56 patients suspected of small hepatocellular carcinoma were admitted between January 2016 and June 2018 were included in the study.All patients accepted spectrum CT scan.The pathological examination was regarded as the gold standard,and the efficacy of energy spectrum CT in the diagnosis of small hepatocellular carcinoma was evaluated.The normalized iodine concentration(NIC)and normalized water concentratio(NWC)of multi-phase hepatocellular carcinoma by energy spectrum CT were compared.And the diagnostic efficacy of energy spectrum CT on microvascular invasion was evaluated.Results The sensitivity,specificity,accuracy rate and positive and negative predictive values of energy spectrum CT in the diagnosis of small hepatocellular carcinoma were 93.48%,80.00%,91.07%,95.56%and 72.73%respectively,and the area under the ROC curve of energy spectrum CT was 0.867.The arterial NIC of patients with microvascular invasion was higher than that of patients without microvascular invasion(P<0.05).There were no statistically significant differences in the portal phase NIC,arterial phase NWC and portal phase NWC between patients with microvascular invasion and without microvascular invasion(P>0.05).ROC curve results showed that the critical value,AUC,sensitivity,specificity and Youden index of NIC in the diagnosis of microvascular invasion of small hepatocellular carcinoma were 0.135,0.881,0.784,0.8 and 0.584.Conclusion Spectrum CT material decomposition technique was helpful for the quantitative diagnosis of small hepatocellular carcinoma.

关 键 词：小肝癌 能谱CT 术前评估 

分 类 号：R735[医药卫生—肿瘤] R730[医药卫生—临床医学]