双能量CT在鉴别眼眶炎性假瘤和MALT淋巴瘤中的应用初探  

A Preliminary Study of Dual-Energy CT in Distinguishing Idiopathic Orbital Inflammatory Pseudotumor from Mucosal-Associated Lymphoid Tissue Lymphoma

作　　者：王宇喆 王鹏 唐作华 姚振威 段斐 占杨 WANG Yuzhe;WANG Peng;TANG Zuohua;YAO Zhenwei;DUAN Fei;ZHAN Yang(Department of Radiology,Eye&ENT Hospital,Fudan University;Department of Radiology,Huashan Hospital,Fudan University;Shanghai Institute of Medical Imaging)

机构地区：[1]复旦大学附属眼耳鼻喉科医院放射科 [2]复旦大学附属华山医院放射科 [3]上海市影像医学研究所

出　　处：《中国医学计算机成像杂志》2021年第6期495-499,共5页Chinese Computed Medical Imaging

基　　金：复旦大学附属眼耳鼻喉科医院“优秀医师-优秀临床研究者”计划(SYA202007)。

摘　　要：目的:初步探讨双能量CT (DECT)在鉴别特发性眼眶炎性假瘤(IOIP)与黏膜相关淋巴组织(MALT)淋巴瘤中的应用价值,明确可用于鉴别两者的DECT参数。方法:回顾性分析经病理证实的5例IOIP患者及5例MALT淋巴瘤患者的DECT检查资料。对DECT参数进行独立样本t检验,绘制受试者操作特征(ROC)曲线,明确鉴别IOIP与MALT淋巴瘤的最佳DECT参数。结果:眼眶MALT淋巴瘤的碘浓度(IC)、40~100keV (间隔20keV)处虚拟单色图像(VMI) CT值等均显著高于IOIP (P<0.05)。有效原子序数(Zeff)、碘光谱衰减曲线斜率k值及120~180keV (间隔20keV)处的VMI在两者中差异均无统计学意义。60keV处VMI ROC曲线下面积(AUC)最高(AUC=0.96,灵敏度为100%,特异度为80%,准确度为80%)。结论:DECT的定量参数IC及40~100keV (间隔20keV) VMI可用于鉴别诊断眼眶IOIP与MALT淋巴瘤,并且60keV VMI诊断效能最高。Purpose: To study the application value of dual-energy CT(DECT) in the identification of idiopathic orbital inflammatory pseudotumor(IOIP) and mucosal-associated lymphoid tissue(MALT) lymphoma, and to clarify the DECT parameters that can be used to distinguish them.Methods: The DECT data of 5 patients with IOIP and 5 patients with MALT lymphoma confirmed by pathology results were retrospectively analyzed. The DECT parameters were measured and compared by independent sample t-test. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic performance, and area under the ROC curve(AUC) was compared to select the best diagnostic parameters.Results: Significantly higher iodine concentration(IC) and the virtual monochromatic image(VMI) at 40 keV-100 keV(interval 20 keV) were found in MALT lymphoma than those in IOIP(P<0.05). There was no significant difference in effective atomic number(Zeff), the slope k value of spectral attenuation curve and 120 keV-180 keV(interval 20 keV) VMI between MALT lymphoma and IOIP. For discriminating MALT lymphoma from IOIP, AUC of 60 keV VMI was the highest in all parameters(AUC, 0.96;sensitivity, 100%;specificity, 80%;accuracy, 80%).Conclusion: DECT’s quantitative parameters IC and 40 keV-100 keV(interval 20 keV) VMI can be helpful to distinguish between IOIP and MALT lymphoma;moreover, 60 keV VMI is the diagnostic parameter with the best performance.

关 键 词：特发性眼眶炎性假瘤 黏膜相关淋巴组织(MALT)淋巴瘤 双能量CT 

分 类 号：R445.3[医药卫生—影像医学与核医学]