能谱CT鉴别鼻腔鼻窦肿块样息肉与肿瘤  

Spectrum CT to distinguish mass-like polyps from tumors in the nasal cavity and sinus

作　　者：危春容 严映 吕艳娥 冯瑶杰 张梦梅 杨亚英[1] 韦文彦 WEI Chunrong;YAN Ying;Lü Yan'e;FENG Yaojie;ZHANG Mengmei;YANG Yaying;WEI Wenyan(Department of Medical Imaging,the First Affiliated Hospital of Kunm ing 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,云南昆明650032

出　　处：《实用放射学杂志》2020年第11期1745-1748,1785,共5页Journal of Practical Radiology

摘　　要：目的探讨双能CT能谱曲线斜率(K)鉴别鼻腔鼻窦肿块样息肉与肿瘤的价值.方法选取98例术前行鼻窦双能量CT增强扫描并经术后病理证实的鼻腔鼻窦肿块患者.根据病理类型分为息肉组(33例)、良性肿瘤组(26例)和恶性肿瘤组(39例),测量并比较3组间动脉期能谱曲线K(K40~70 keV、K70~100 keV、K100~140 keV)的差异.进一步将98例病变分为息肉组(33例)及肿瘤组(65例),绘制ROC曲线,评估其诊断效能.结果动脉期能谱曲线K在40~70 keV、70~100 keV、100~140 keV 3个能量节段内,良性肿瘤组和恶性肿瘤组均高于息肉组(P<0.05),其中恶性肿瘤组高于良性肿瘤组(P<0.05).动脉期能谱曲线K在3个能量节段鉴别鼻腔鼻窦肿块样息肉与肿瘤的AUC分别为0.982、0.916及0.932(P=0.000);以K=1.31为临界值鉴别诊断鼻腔鼻窦肿块样息肉与肿瘤的敏感度及特异度分别为96.90%及97.00%.结论双能CT能谱曲线K可提高鼻腔鼻窦肿瘤性病变的检出率,K40~70 keV具有较高的诊断效能,有助于鉴别鼻腔鼻窦肿块样息肉与肿瘤.Objective To explore the value of dual-energy CT energy spectrum curve slope(K)in distinguishing mass-like polyps from tumors in the nasal cavity and sinus.Methods This study enrolled 98 patients with nasal sinus masses who completed dual-energy CT enhanced scan before the operation,and all patients were confirmed pathologically.According to pathological types,the patients were divided into polyp group(33 cases),benign tumor group(26 cases)and malignant tumor group(39 cases).The slope of energy spectrum curve in arterial phase(K40~70 keV、K70~100 keV、K100~140 keV)between the three groups were compared.98 cases were further divided into polyp group(33 cases)and tumor group(65 cases),ROC curves were drawn to evaluate diagnostic efficacy.Results The slope of energy spectrum curve in arterial phase within the three energy segments(40-70 keV,70-100 keV,100-140 keV),both the benign tumor group and the malignant tumor group were higher than the polyp group(P<C0.05),and the malignant tumor group was higher than the benign tumor group(P<10.05).The AUC of the slope at the three energy segments in distinguishing mass-like polyps from tumors in the nasal sinus was 0.982,0.916 and 0.932(P=0.000);K=1.31 as cutoff value,the sensitivity and specificity were 96.90%and 97.00M.Conclusion The slope of dual-energy CT energy spectrum curve can increase the detection rate of tumorous lesions in the nasal cavity and sinuses,K40-70 keV has better diagnostic efficacy,which is helpful to distinguish mass-like polyps from tumors in the nasal cavity and sinus.

关 键 词：鼻腔 鼻窦 计算机体层成像 

分 类 号：R739.62[医药卫生—肿瘤] R814.42[医药卫生—临床医学]