能谱CT定量参数值鉴别鼻咽淋巴瘤及鼻咽癌的价值  

Clinical Value of Quantitative Parameters by Spectral CT in Distinguishing Nasopharyngeal Lymphoma and Nasopharyngeal Carcinoma

作　　者：魏一娟[1] 贾飞[2] 苏蕾[1] 查开继[1] 高剑波[1] WEI Yijuan;JIA Fei;SU Lei;ZHA Kaiji;GAO Jianbo(Department of Radiology,The First Affiliated Hospital,Zhengzhou Uni-versity;Department of Radiation Oncology,The First Affiliated Hospital,Zhengzhou University)

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

出　　处：《中国医学计算机成像杂志》2021年第6期500-504,共5页Chinese Computed Medical Imaging

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200377)。

摘　　要：目的:探讨能谱CT定量参数值在鼻咽淋巴瘤、鼻咽癌鉴别诊断的临床价值。方法:应用能谱CT对30例鼻咽淋巴瘤、20例鼻咽癌患者进行GSI双期增强扫描。测量并计算鼻咽部肿瘤组织内动脉期(AP)、静脉期(VP)的碘浓度(IC)、标准碘浓度(NIC)及碘浓度差(ICD)及3组不同能量范围的能谱衰减曲线斜率K,并绘制受试者操作特征(ROC)曲线,利用ROC曲线下面积(AUC)衡量各能谱参数的鉴别诊断效能。结果:鼻咽淋巴瘤组IC_(AP)、NIC_(VP)、K_(VP40-70)、K_(VP40-100)均低于鼻咽癌组(均P<0.01),该4个参数对二者的鉴别均有中等诊断效能,AUC分别为0.725、0.820、0.736、0.755。NIC_(VP)的AUC最大,当以0.57为阈值时,其鉴别鼻咽淋巴瘤、鼻咽癌的灵敏度、特异度、阳性预测值和阴性预测值分别为75%、86.7%、84.94%和77.62%。结论:鼻咽淋巴瘤、鼻咽癌能谱CT多定量参数值存在差异,可作为能谱CT鉴别二者的有效指标。Purpose:To explore the clinical value of quantitative parameters of spectral CT in the differential diagnosis of nasopharyngeal lymphoma(NPL)and nasopharyngeal carcinoma(NPC).Methods:Thirty cases of NPC and 20 cases of NPC,which were all confirmed with pathological results,underwent dual phase enhanced scan in spectral CT.Iodine concentration(IC),normalized iodine concentration(NIC),iodine concentration difference(ICD)and spectral attenuation curve slope K in three different energy ranges of arterial phase(AP)and venous phase(VP)were measured and calculated.The receiver operating characteristic(ROC)curve was drawn and area under the ROC curve(AUC)was used to measure the differential diagnosis efficiency of each parameter.Results:The IC_(AP),NIC_(VP),K_(VP40-70),K_(VP40-100) of NPL were lower than those of NPC group(all P<0.01).The AUC of the four parameters was 0.725,0.820,0.736 and 0.755,respectively.The AUC of NIC_(VP) was the highest,and the best cut-off point was 0.57,the sensitivity,specificity,positive predictive value and negative predictive value were 75%,86.7%,84.94%and 77.62%.Conclusion:Quantitative parameters from spectral CT are helpful in differentiating NPL and NPC.

关 键 词：CT能谱成像 鼻咽癌 鼻咽淋巴瘤 受试者操作特征曲线 

分 类 号：R445.3[医药卫生—影像医学与核医学]