CT增强定量参数预测肾透明细胞癌WHO/ISUP分级  

Prediction of WHO/ISUP Grading of Renal Clear Cell Carcinoma by Quantitative Parameters of CT Enhancement Scanning

作　　者：张晓金 翟建[3] 张虎 谢闵 吴树剑 过永 ZHANG Xiaojin;ZHAI Jian;ZHANG Hu;XIE Min;WU Shujian;GUO Yong(Department of Medical Imaging,Wuhu Second People's Hospital,Wuhu 241000,China;Department of Patholog,Wuhu Second People's Hospital,Wuhu 241000,China;Medical Imaging Center,Yijishan Hospital,Wannan Medical College,Wuhu 241000,China)

机构地区：[1]芜湖市第二人民医院医学影像科,安徽芜湖241000 [2]芜湖市第二人民医院医学病理科,安徽芜湖241000 [3]皖南医学院弋矶山医院医学影像中心,安徽芜湖241000

出　　处：《CT理论与应用研究（中英文）》2023年第6期746-752,共7页Computerized Tomography Theory and Applications

摘　　要：目的:探讨CT增强定量参数术前预测肾透明细胞癌(ccRCC)世界卫生组织/国际泌尿病理学会(WHO/ISUP)分级的价值。方法:连续搜集行手术治疗的98例ccRCC患者临床和CT增强资料,根据WHO/ISUP分级分为低级别组(76例)和高级别组(22例)。比较CT增强定量参数两组间差异及各参数预测ccRCC WHO/ISUP分级的诊断效能,并进行外部验证,找寻泛化能力最佳的CT增强定量参数。结果:两组间皮质期CT值、皮质期净增值、皮质期强化率、实质期CT值、实质期净增值、实质期强化率差异均有统计学意义,AUC值分别依次为0.834、0.871、0.900、0.707、0.678和0.762;截断值分别依次为123.5 HU、71HU、0.73、87.5HU、54HU、0.67;皮质期强化率诊断效能最高,AUC=0.900,敏感度为0.842,特异度为0.864;外部验证结果显示皮质期强化率诊断效能(AUC=0.867)优于皮质期CT值(AUC=0.735)、皮质期净增值(AUC=0.709),Z值分别为2.134和2.417。结论:CT增强定量参数可用于预测ccRCC WHO/ISUP分级,皮质期强化率是诊断效能最高、泛化能力最佳的CT增强定量参数。Objective:To investigate the potential of CT-enhanced quantitative parameters for preoperative prediction of WHO/ISUP grading for renal clear cell carcinoma(ccRCC).Methods:The study involved collecting clinical and CT-enhanced data of 98 patients with ccRCC,who were then classified into low level group(76 cases)and high level group(22 cases)based on the WHO/ISUP classification.Differences in CT-enhanced quantitative parameters between the two groups were compared,and the diagnostic efficacy of each parameter for predicting ccRCC WHO/ISUP grading was evaluated.External verification was conducted to identify CT-enhanced quantitative parameters with the best generalization ability.Results:There were significant differences in the CT value,net increment,and enhancement rate in both cortical and substantive phases between the two groups.The AUC values were 0.834,0.871,0.900,0.707,0.678,and 0.762,respectively.The cut-off values were 123.5 HU,71 HU,0.73,87.5 HU,54 HU,0.67,respectively.The diagnostic efficacy of cortical enhancement rate was the highest with an AUC of 0.900,a sensitivity of 0.842,and a specificity of 0.864.The external validation results revealed that the diagnostic efficacy of cortical phase enhancement rate(AUC=0.867)was better than that of cortical phase CT(AUC=0.735)and cortical phase net increment(AUC=0.709).The Z values were 2.134 and 2.417,respectively.Conclusion:The quantitative parameters of CT enhancement can be used to predict ccRCC WHO/ISUP grading.Cortical phase enhancement rate is the parameter with the highest diagnostic efficiency and the best generalization ability.

关 键 词：体层摄影术 X线计算机 透明细胞肾癌 病理分级 

分 类 号：R814[医药卫生—影像医学与核医学] TP391[医药卫生—放射医学]