能谱CT成像在腮腺基底细胞腺瘤及多形性腺瘤鉴别诊断中的应用价值  

Application value of spectral CT imaging in the differential diagnosis of parotid basal cell adenoma and pleomorphic adenoma

作　　者：罗冰 林景兴 郭莉[1] 张丽丽[1] 曾成龙 潘爱珍[1] 徐志锋[1] LUO Bing;LIN Jingxing;GUO Li;ZHANG Lili;ZENG Chenglong;PAN Aizhen;XU Zhifeng(Department of Radiology,Foshan First People’s Hospital,Guangdong Province,Foshan528000,China)

机构地区：[1]广东省佛山市第一人民医院影像科,广东佛山528000

出　　处：《中国医药导报》2023年第13期148-151,共4页China Medical Herald

基　　金：广东省基础与应用基础研究基金项目(2019A 1515110976);广东省佛山市“登峰计划”项目(2020B003)。

摘　　要：目的探讨能谱CT成像在腮腺基底细胞腺瘤(BCA)与多形性腺瘤(PA)鉴别诊断中的应用价值。方法收集2018年10月至2021年8月广东省佛山市第一人民医院经病理确诊的腮腺BCA及PA病例共37例,其中BCA组17例,PA组20例。患者均采用Discovery CT行颌面部平扫及能谱双期增强扫描,测量并记录病灶的碘浓度(IC)及40、70、100、140 keV单能量CT值,获取能谱曲线斜率;受试者操作特征曲线评估各参数对BCA及PA的鉴别诊断效能。结果两组肿物形态比较,差异有统计学意义(P<0.05)。动脉期,BCA组40 keV单能量CT值、能谱曲线斜率K1、IC高于PA组,差异有统计学意义(P<0.05);静脉期,BCA组40、70 keV单能量CT值,能谱曲线斜率K1、K2、K3,IC高于PA组,差异有统计学意义(P<0.05)。动脉期能谱曲线斜率K1诊断BCA及PA的临界值为1.19,曲线下面积为0.994,灵敏度为94.1%,特异度为100%。结论使用能谱CT成像技术能够有效鉴别诊断BCA与PA,为临床提供重要参考依据。Objective To investigate the application value of spectral CT imaging in the differential diagnosis of parotid basal cell adenoma(BCA)and pleomorphic adenoma(PA).Methods A total of 37 cases of parotid BCA and PA diagnosed pathologically in the Foshan First People’s Hospital,Guangdong Province from October 2018 to August 2021 were collected,including 17 cases in BCA group and 20 cases in PA group.All patients underwent maxillofacial plain and dual-phase enhanced energy spectral scans using Discovery CT scanner,the iodine concentration(IC),monochromatic CT value of 40,70,100 keV,and 140 keV were measured and recorded respectively,and the spectral curve slope were obtained;the differential diagnosis of BCA and PA was evaluated by receiver operating characteristic curve.Results There was statistical significance in tumor morphology of two groups(P<0.05).In arterial stage,monochromatic CT value of 40 keV,spectral curve slope K1 and IC in BCA group were higher than those in PA group,and the differences were statistically significant(P<0.05);in venous stage,monochromatic CT values of 40,70 keV,spectral curve slope K1,K2,and K3,and IC in BCA group were higher than those in PA group,and the differences were statistically significant(P<0.05).The cut-off value of arterial stage spectral curve slope K1 for the diagnosis of BCA and PA was 1.19,the area under the curve was 0.994,the sensitivity was 94.1%,and the specificity was 100%.Conclusion The use of spectral CT imaging technology can effectively differentiate the diagnosis of BCA and PA,and provide an important reference for clinical.

关 键 词：能谱CT成像 计算机体层成像 基底细胞腺瘤 多形性腺瘤 

分 类 号：R816.4[医药卫生—放射医学]