能谱CT成像在评估肝细胞癌微血管侵犯中的价值  

Value of Energy Spectrum CT Imaging in Evaluating Microvascular Invasion of Hepatocellular Carcinoma

作　　者：李大铭 张玉婷[2] 马小梅[1] LI Da-ming;ZHANG Yu-ting;MA Xiao-mei(Department of Radiology,Gansu Provincial Hospital,Lanzhou 730013,Gansu Province,China;Department of Radiology,Lanzhou University Second Hospital,Lanzhou 730030,Gansu Province,China)

机构地区：[1]甘肃省人民医院放射科,甘肃兰州730013 [2]兰州大学第二医院放射科,甘肃兰州730030

出　　处：《中国CT和MRI杂志》2024年第1期91-93,106,共4页Chinese Journal of CT and MRI

基　　金：甘肃省青年科技基金计划(21JR7RA639)。

摘　　要：目的探讨能谱CT定量评估肝细胞癌微血管侵犯的临床价值。方法纳入51例行双期对比增强能谱CT的肝细胞癌患者。从能谱CT图测得肿瘤CT值和碘浓度(IC)。计算能谱曲线的斜率(Slope)、标准化碘浓度(NIC)以及动静脉期之间的碘浓度差比率(RICAP-VP)。根据手术病理结果,肿瘤被确定为有或无微血管侵犯。采用t检验或卡方检验分析两组间的差异,采用受试者工作特征曲线(ROC)评价变量的诊断性能。结果有和无微血管侵犯组在动脉期的IC、NIC、Slope和RICAP-VP有显著差异(P<0.05)。使用3.245作为动脉期的Slope的阈值,可以在ROC分析中获得0.806的曲线下面积(AUC)值来区分有和没有微血管侵犯的肿瘤。CT值在70keV时AUC为0.577,在40keV时提高到0.757。结论能谱CT提供了比常规CT更多定量参数,以促进区分有和没有微血管侵犯的肝细胞癌。Objective To investigate the clinical value of energy spectrum CT in the quantitative assessment of microvascular invasion(MVI)of hepatocellular carcinoma(HCC).Methods 51 patients with HCC who underwent contrast enhanced spectrum CT in arterial phase(AP)and portal venous phase(VP)were enrolled.Tumour CT value and iodine concentration(IC)were measured from spectrum CT images.The slope of spectrum curve,normalized iodine concentration(NIC)and ratio of IC difference between AP and VP(RICAP–VP)were calculated.Tumors were identified as either with or without MVI based on histopathological results.Differences between the two groups were analysed using the t-test or chi-square test,and the diagnostic performance of variables was evaluated using a receiver operating characteristic(ROC)curve.Results There were significant differences in IC,NIC and slope in AP and RICAP–VP between the groups with and without MVI(all P<0.05).Using 3.245 as the threshold for Slope AP,one could obtain an area-under-curve(AUC)of 0.806 in ROC analysis to differentiate between tumors with and without MVI.AUC was 0.577 with CT value at 70 keV and improved to 0.757 at 40 keV.Conclusion Energy spectrum CT provides more quantitative parameters than conventional CT to facilitate the distinction between HCC with and without MVI.

关 键 词：能谱成像 对比增强CT 肝细胞癌 微血管侵犯 

分 类 号：R735.7[医药卫生—肿瘤]