能谱CT定量参数值鉴别颌面部鳞癌及感染的价值  

Clinical Value of Quantitative Parameters by Spectral CT in Distinguishing Maxillofacial Squamous Cell Carcinoma and Infection

作　　者：魏一娟[1] 贾飞[2] 唐丽[1] 查开继[1] 高剑波[1] WEI Yijuan;JIA Fei;TANG Li(Department of Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou Henan,P.R.China)

机构地区：[1]郑州大学第一附属医院放射科,450052 [2]郑州大学第一附属医院放射治疗部,450052

出　　处：《临床放射学杂志》2021年第7期1286-1290,共5页Journal of Clinical Radiology

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20200377)。

摘　　要：目的探讨能谱CT定量参数值在颌面部鳞癌及颌面部感染鉴别诊断中的临床价值。方法回顾性分析经病理证实的颌面部鳞癌及经抗感染治疗有效证实的颌面部感染各30例患者的资料。所有患者均在能谱CT行能谱模式双期增强扫描,在动脉期(AP)、静脉期(VP)能谱图像上测量颌面部鳞癌、感染病灶内的碘浓度(IC),计算标准化碘浓度(NIC)及三组不同能量范围的能谱衰减曲线斜率K(K_(40~70)、K_(40~100)、K_(40~140)),采用独立样本t检验对两组病变的IC、NIC、斜率K值进行比较,并使用受试者工作特征曲线(ROC)评估诊断效能。结果颌面部鳞癌动、静脉期IC、NIC均高于颌面部感染(P<0.05);颌面部鳞癌动、静脉期各斜率K均显著高于颌面部感染(P<0.001);动、静脉期IC、NIC及各能量范围的能谱曲线斜率K对两者的鉴别均有一定的价值,K_(AP40~100)曲线下面积(AUC)最大,其阈值1.55时鉴别两者的敏感度和特异度分别为93.30%、80.00%。结论能谱CT碘浓度分析、能谱曲线斜率对颌面部鳞癌与颌面部感染的鉴别有意义,且能谱曲线斜率鉴别诊断效能优于碘浓度分析,可作为能谱CT鉴别二者的有效指标。Objective To investigate the clinical value of quantitative parameters of spectral CT in the differential diagnosis of maxillofacial squamous cell carcinoma and infection.Methods The data of 30 patients with maxillofacial squamous cell carcinoma and 30 patients with maxillofacial infection confirmed by pathology or effective anti-infective therapy were retrospectively collected.All patients underwent dual phase contrast-enhanced scanning with GSI mode on spectral CT.The iodine concentration(IC)in lesions in arterial phase(AP)and venous phase(VP)was measured,the normalized iodine concentration(NIC)and the spectral attenuation curve slope K in three different energy ranges(K_(40-70),K_(40-100),K_(40-140))was calculated.The IC,NIC and slope K values of the two groups was compared by independent sample t test,and the diagnostic efficacy was evaluated by ROC curve.Results The IC、NIC in arterial phase and venous phase of maxillofacial squamous cell carcinoma were higher than that of maxillofacial infection(P<0.05);the slope k in arterial phase and venous phase of maxillofacial squamous cell carcinoma was significantly higher than that of maxillofacial infection(P<0.001).The IC,NIC and the slope K of energy spectrum curve are of certain value in the differential diagnosis.The AUC of K_(AP40-100) was the highest,and the best cut-off point was 1.55,the sensitivity,specificity,were 93.30%and 80.00%,respectively.Conclusion Spectral CT imaging with the quantitative iodine concentration and the energy spectrum curve slope have significance in differential diagnosis of maxillofacial squamous cell carcinoma and maxillofacial infection,the energy spectrum curve slope is superior to the iodine concentration analysis in the differential diagnosis,which can be used as an effective index to differentiate the two kinds of lesions.

关 键 词：能谱CT成像 颌面部鳞癌 颌面部感染 受试者工作特征曲线 

分 类 号：R739.8[医药卫生—肿瘤]