增强CT联合直方图分析鉴别诊断腮腺Warthin瘤与多形性腺瘤  

Enhanced CT combined with histogram analysis for differential diagnosis of Warthin tumor and polymorphic adenoma of parotid gland

作　　者：褚相乐 王勇[1] 王志芳[1] 刘海燕 李杰 黄勇华[1] CHU Xiangle;WANG Yong;WANG Zhifang;LIU Haiyan;LI Jie;HUANG Yonghua(Department of Radiology,Puyang Oilfield General Hospital,Puyang 457001,China)

机构地区：[1]濮阳市油田总医院放射科,河南濮阳457001

出　　处：《中国医学影像技术》2020年第8期1177-1182,共6页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察增强CT联合直方图分析鉴别诊断腮腺Warthin瘤与多形性腺瘤(PA)的价值。方法对37例Warthin瘤(Warthin瘤组)及28例PA(PA组)行颌面部CT平扫及增强检查,测量平扫及增强CT动脉期(AP)及静脉期(VP)病灶CT值,记录其强化方式及双期增强净强化值,计算增强CT相关直方图参数,包括均值(Mean)、标准差(StdDev)、最小值(Min)、最大值(Max)、中位数(Median)、偏度(Skew)及峰度(Kurt)。比较组间各参数值差异,绘制各参数鉴别诊断腮腺Warthin瘤与PA的ROC曲线,分析其诊断效能。结果组间各期CT值、AP净强化值及强化方式差异均有统计学意义(P均<0.05),MeanAP、MinAP、MaxAP、MedianAP、SkewAP、MeanVP、StdDevVP、MinVP、MedianVP及SkewVP差异均有统计学意义(P均<0.05)。强化方式、AP净强化值、MeanAP、MinAP、MaxAP、MedianAP及SkewAP鉴别诊断PA与Warthin瘤的AUC及约登指数均高于VP直方图参数,其中SkewAP的约登指数最高(0.71),AUC为0.88;强化方式+SkewAP联合诊断效能最高,其AUC、约登指数、敏感度及特异度分别为0.94、0.80、83.58%及96.43%。结论增强CT联合AP直方图分析有助于鉴别腮腺Warthin瘤与多形性腺瘤,各参数联合诊断效能优于单一参数。Objective To investigate the value of enhanced CT combined with histogram analysis in differential diagnosis of Warthin tumor and pleomorphic adenoma(PA)of parotid.Methods Maxillofacial plain and enhanced CT were performed on 37 patients with Warthin tumor(Warthin tumor group)and 28 patients with PA(PA group).CT values of plain,arterial phase(AP)and venous phase(VP)CT of lesions were measured,and the enhanced patterns and pure enhanced values were recorded.Then the parameters of histogram analysis,including the mean,standard deviation(StdDev),minimum(Min),maximum(Max),Median,skewness(Skew)and kurtosis(Kurt)were calculated.The differences of all parameters were compared between groups.ROC curves of parameters being statistically different between groups were drawn for differential diagnosis of Warthin tumor and PA of parotid gland,and the corresponding diagnostic efficacy were analyzed.Results There were statistically differences of CT values in each phase,AP pure enhanced values and enhanced patterns between groups(all P<0.05),and MeanAP,MinAP,MaxAP,MedianAP,SkewAP,MeanVP,StdDevVP,MinVP,MedianVPand SkewVPalso showed significant differences(all P<0.05).AUC and Youden indexes of enhanced pattern,AP pure enhanced value,MeanAP,MinAP,MaxAP,MedianAPand SkewAP were all higher than those of VP histogram parameters in differential diagnosis of PA and Warthin tumor.SkewAPhad the highest Youden index(0.71),with AUC of 0.88.The diagnostic efficacy enhanced pattern+SkewAP was the most effective,with AUC,Youden index,sensitivity and specificity of 0.94,0.80,83.58%and 96.43%,respectively.Conclusion Enhanced CT combined with histogram analysis based on AP images were helpful to differential diagnosis of Warthin tumor and polymorphic adenoma of parotid.The diagnosis performance of combined parameters was better than that of single parameter.

关 键 词：腮腺 腺瘤 多形性 腺淋巴瘤 诊断 鉴别 体层摄影术 X线计算机 直方图 

分 类 号：R739.8[医药卫生—肿瘤] R814.42[医药卫生—临床医学]