双能CT及MRI诊断喉癌前联合侵犯的价值  

Diagnostic Value of Dual-Energy CT and MRI in Laryngeal Carcinoma with Anterior Commissure Involvement

作　　者：吕艳娥 瞿姣 何波[1] 付蓝琦 潘馨梦 王娟[1] 杨亚英[1] LV Yane;QU Jiao;HE Bo(Department of Radiology,The First Affiliated Hospital of Kunming Medical University,Kuming,Yunnan Province 650032,P.R.China)

机构地区：[1]昆明医科大学第一附属医院医学影像科,650032

出　　处：《临床放射学杂志》2021年第8期1486-1490,共5页Journal of Clinical Radiology

摘　　要：目的对比双能CT及MRI诊断喉癌前联合(AC)侵犯的价值。方法回顾性分析本院2017年6月至2020年1月术前同时接受喉部双能CT、MRI平扫及增强扫描的62例喉癌患者的临床及影像学资料,以手术病理为金标准,分别计算双能CT、MRI及二者联合诊断喉癌AC侵犯的敏感度、特异度、准确度、阳性预测值及阴性预测值,以评估诊断效能。结果术后病理示35例为喉癌AC侵犯阳性。采用双能CT混合能量图像结合碘图诊断AC侵犯的敏感度、特异度、准确度、阳性预测值及阴性预测值分别为88.57%(31/35)、92.59%(25/27)、90.32%(56/62)、93.94%(31/33)、86.20%(25/29),而MRI平扫及增强图像的诊断效能分别为94.29%(33/35)、88.89%(24/27)、91.94%(57/62)、91.67.%(33/36)、92.31%(24/26),以及二者联合的诊断效能分别为100.00%(35/35)、81.48%(22/27)、91.94%(57/62)、87.50%(35/40)、100.00%(22/22)。双能CT混合能量图像结合碘图、MRI平扫及增强图像诊断前联合侵犯的一致性较好(Kappa值=0.772,P<0.001),其中双能CT诊断AC侵犯的阳性率为53.2%,稍高于MRI诊断前联合侵犯阳性率(41.9%)。结论双能CT及MRI均能较准确地判断喉癌AC侵犯,二者联合诊断能进一步提高AC侵犯的诊断效能。Objective To compare the value of dual-energy CT(DECT)and MRI in diagnosis of anterior commissure involvement in laryngeal carcinoma.Methods The clinical and image data of 62 laryngeal carcinoma patients confirmed by pathology underwent preoperative DECT and MRI examinations from June 2017 to January 2020 were analyzed retrospectively.The accuracy,specificity,sensitivity,positive predictive value and negative predictive value of DECT,MR and the combination diagnosis ofanterior commissure involvement in laryngeal carcinomawere measured.Results Among 62 patients,35 cases were positive for laryngeal carcinoma with anterior commissure involvement confirmed by pathology.The accuracy,sensitivity,specificity,negative predictive value and positive predictive value were 88.57%(31/35)、92.59%(25/27)、90.32%(56/62)、93.94%(31/33)、86.20%(25/29),94.29%(33/35)、88.89%(24/27)、91.94%(57/62)、91.67.%(33/36)、92.31%(24/26),100.00%(35/35)、81.48%(22/27)、91.94%(57/62)、87.50%(35/40)、100.00%(22/22)in blending energy images of DECT combined with iodine images,MRI plain and enhanced scanning image,and the combined diagnosis.The blending energy images of DECT combined with iodine images,MRI plain scan and enhanced image have good consistency in the diagnosis of laryngeal carcinomawith anterior commissure involvement(Kappa value=0.772,P<0.001),and the positive rate of anterior commissure involvementin DECT is 53.2%,slightly higher than MRI(41.9%).Conclusion Both dual-energy CT and MRI can accurately diagnose laryngeal carcinoma with anterior commissure involvement.The combined diagnosis of the two can further improve the diagnostic efficiency of the anterior commissure involvement in laryngeal carcinoma.

关 键 词：喉癌 前联合 双能CT 磁共振成像 

分 类 号：R739.65[医药卫生—肿瘤]