能谱CT多参数在肾母细胞瘤病理分型中的应用价值  

Application value of energy spectrum CT multi-parameters in pathological classification of nephroblastoma

作　　者：辛涛 徐超 于啸 XIN Tao;XU Chao;YU Xiao(Department of Medical Imaging,Xuzhou Children’s Hospital,Xuzhou,Jiangsu Province 221000,China)

机构地区：[1]徐州市儿童医院医学影像科,江苏徐州221000

出　　处：《实用放射学杂志》2023年第12期2026-2029,2077,共5页Journal of Practical Radiology

基　　金：徐州市重点研发计划(农业与社会发展)项目(KC19182)。

摘　　要：目的探讨能谱CT检查的多参数在肾母细胞瘤病理分型中的应用价值。方法回顾性选取行能谱CT检查的肾母细胞瘤患儿30例,分别对肿瘤及腹主动脉的碘(I)值及CT值进行3期采集,计算出标准化碘浓度(NIC)、I值强化比、CT值强化比及I值/CT值强化比,进行统计学分析。结果统计学分析表明,在NIC及多参数的比较中,3型肾母细胞瘤之间存在统计学差异(P<0.05)。在能谱曲线斜率比较中,斜率由大至小依次为胚芽型肾母细胞瘤,混合型肾母细胞瘤,间叶型肾母细胞瘤,差异有统计学意义(P<0.05)。通过受试者工作特征(ROC)曲线分析发现,NIC和I值/CT值强化比和能谱曲线斜率在高度风险类型与中度风险类型肾母细胞瘤的鉴别中,其曲线下面积(AUC)为0.91~0.96,灵敏度75%~95%,特异性90%以上。结论能谱CT多参数可以作为肾母细胞瘤病理分型的依据。NIC和I值/CT值强化比和能谱曲线斜率可以作为肾母细胞瘤高、中风险病理类型的鉴别指标。Objective To explore the application value of multi-parameters of energy spectrum CT in the pathological classification of nephroblastoma.Methods A total of 30 children with nephroblastoma who were underwent energy spectrum CT examination were enrolled in this study,retrospectively.The iodine(I)value and CT value of tumor and abdominal aorta were collected in three phases,respectively.The normalized iodine concentration(NIC),I value enhancement ratio,CT value enhancement ratio and I value/CT value enhancement ratio were calculated and statistically analyzed.Results Statistical analysis showed that in the comparison of NIC and multi-parameters,there were statistical differences between the three types of nephroblastoma(P<0.05).In the comparison of the slopes of energy spectrum curves,the slopes from large to small were respectively germ nephroblastoma,mixed nephroblastoma and mesenchymal nephroblastoma,and the differences were statistically significant(P<0.05).Through receiver operating characteristic(ROC)curve analysis,it was found that the NIC and I value/CT value enhancement ratio and slope of energy spectrum curve in the identification of high-risk type and medium-risk type of nephroblastoma,the area under the curve(AUC)was 0.91-0.96,and the sensitivity was 75%-95%,and the specificity was above 90%.Conclusion Multi-parameters of energy spectrum CT can be used as the basis for the pathological classification of nephroblastoma.NIC and I value/CT value enhancement ratio and slope of energy spectrum curve can be used as differential indicators of high and medium-risk pathological types of nephroblastoma.

关 键 词：肾母细胞瘤 标准化碘浓度 强化比 能谱曲线斜率 

分 类 号：R737.11[医药卫生—肿瘤] R814.42[医药卫生—临床医学]