双源CT虚拟去钙技术在椎体转移瘤中的诊断价值  

Diagnostic value of dual-source CT virtual noncalcium in vertebral metastases

作　　者：张嘉[1,2] 李鹍 丁莹莹[1] 王亚松[1] 杜典轲[1] 陶海波 ZHANG Jia;LI Kun;DING Yingying;WANG Yasong;DU Dianke;TAO Haibo(Department of Radiology,the Third Affiliated Hospital of Kunming Medical University,Kunming 650118,China;Department of Medical Imaging,the Third People's Hospital of Yunnan Province,Kunming,650011,China)

机构地区：[1]昆明医科大学第三附属医院放射科,云南昆明650118 [2]云南省第三人民医院医学影像科,云南昆明650011

出　　处：《实用放射学杂志》2022年第4期625-628,633,共5页Journal of Practical Radiology

基　　金：云南省科技厅—昆明医科大学应用基础研究联合专项项目(202101AY070001-181).

摘　　要：目的探讨双源CT虚拟去钙(VNCa)技术对椎体转移瘤的诊断价值.方法回顾性分析经临床确诊恶性肿瘤并椎体转移34例患者胸腰椎线性融合Mixed0.6、VNCa及MRI图像.以MRI检查为参照标准,由2名医师对线性融合Mixed0.6、VNCa图像进行定性分析,比较2种技术对转移椎体的诊断效能;测量并比较正常椎体与椎体转移瘤在VNCa图像中VNCaCT值,并进行受试者工作特征(ROC)曲线分析.结果Mixed0.6图像对转移椎体的诊断敏感性、特异性、假阳性率、假阴性率、阳性预测值、阴性预测值、准确性分别为60.49%、94.72%、5.28%、39.51%、90.74%、73.70%、78.94%;VNCa图像分别为79.91%、96.25%、3.75%、20.09%、94.44%、85.71%、88.99%;VNCa图像诊断转移椎体的敏感性、假阴性率、阴性预测值、准确性优于Mixed0.6图像.椎体转移瘤VNCaCT值明显高于正常椎体,差异有统计学意义(t=15.365,P<0.05).使用VNCaCT值诊断椎体转移瘤时,曲线下面积(AUC)为0.953,最佳临界值为-5.92HU,其诊断敏感性84.6%,特异性95.0%.结论双源CT VNCa是一项简便、无创的量化评估技术,能够提供定量数据,用于分析、诊断椎体转移瘤,具有较高的诊断效能.Objective To explore the value of virtual noncalcium(VNCa)technology in the diagnosis of vertebral metastases with dual-source CT.Methods The thoracolumbar images of linear fusion Mixed0.6,VNCa and MRI of 34 patients who were clinically diagnosed malignant tumor and vertebral metastasis were analyzed retrospectively.Setting MRI images as the reference standards,two musculoskeletal diagnosticians performed a qualitative analysis of the linear fusion Mixed0.6 images and VNCa images,and compared the diagnostic efficacy of the two techniques for vertebral metastases.VNCa CT values of normal vertebral body and vertebral metastases on VNCa images were measured and com pa red,and receiver operating characteristic(ROC)curve analysis was performed.Results The sensitivity,specificity,false positive rate,false negative rate,positive predictive value,negative predictive value and accuracy were 60.49%,94.72%,5.28%,39.51%,90.74%,73.70%and 7&94%for Mixed0.6 image respectively;and 79.91%,96.25%,3.75%,20.09%,94.44%,85.71%and 88.99%for VNCa image respectively.The sensitivity,false negative rate,negative predictive value and accuracy of VNCa image were better than those of Mixed0.6 image.The VNCa CT values of vertebral metastases were much higher than those of normal vertebral body,the difference had statistical significance(t=15.365 P<0.05).When using VNCa CT value to diagnose vertebral metastases,the area under the curve(AUC)was 0.953,the best cut-off value was-5.92 HU,its diagnostic sensitivity was 84.6%,and the specificity was 95.0%.Conclusion Dual-source CT VNCa is a simple and non-invasive quantitative evaluation technique,which can provide quantitative data for the analysis and diagnosis of vertebral metastases with high diagnostic efficiency.

关 键 词：椎体转移瘤 虚拟去钙 双源CT 

分 类 号：R738.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]