能谱CT成像在鉴别肾上腺意外瘤的价值研究  

The Value of Spectral CT Radiomics Features in the Identification of Adrenal Incidentaloma

作　　者：史展[1] 张亚斌 张丹卉 SHI Zhan;ZHANG Ya-bin;ZHANG Dan-hui(Imaging Center,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan Province,China)

机构地区：[1]河南科技大学第一附属医院影像中心,河南洛阳471000

出　　处：《中国CT和MRI杂志》2024年第5期123-125,149,共4页Chinese Journal of CT and MRI

基　　金：河南省科技攻关计划项目(LHGJ20210588)。

摘　　要：目的分析能谱CT成像在鉴别肾上腺意外瘤的价值。方法选择本院2020年10月至2023年5月期间收治的29例肾上腺意外瘤患者为研究对象,对其临床资料进行回顾性分析,所有患者经手术病理均证实为肾上腺意外瘤,全部开展了CT平扫和能谱CT扫描,对其检测结果进行分析。结果肾上腺腺瘤患者的囊变例数、肿块大小、门脉期均匀强化例数、平扫CT值和肾上腺嗜铬细胞瘤患者对比,有显著差异(P<0.05)肾上腺腺瘤动脉期40-140KeV单能量的CT值和肾上腺嗜铬细胞瘤相比,肾上腺腺瘤门脉期70-140KeV单能量的CT值和肾上腺嗜铬细胞瘤相比,差异显著(P<0.05)肾上腺腺瘤动脉期和门脉期的NIC明显低于肾上腺嗜铬细胞(P<0.05)。肾上腺腺瘤动脉期NHIC明显低于肾上腺嗜铬细胞(P<0.05)。肾上腺腺瘤门脉期NHIC和肾上腺嗜铬细胞瘤无明显对比差异(P>0.05)。动脉期NIC鉴别诊断肾上腺腺瘤、肾上腺嗜铬细胞瘤的ROC曲线面积最大,多于门脉期NIC和动脉期NHIC。动脉期NIC敏感度和特异度高于门脉期NIC和动脉期NHIC。动脉期NIC的准确率高于门脉期NIC和动脉期NHIC。结论能谱CT影像学特征在鉴别诊断肾上腺意外瘤中的肾上腺腺瘤和肾上腺嗜铬细胞瘤有显著作用,而动脉期NIC的敏感度、特异度、准确率均较高。Objective To analyze the value of spectral CT radiomics features in the identification of adrenal incidentaloma.Methods 29 patients with adrenal incidental tumors admitted to our hospital from October 2020 to May 2023 were selected as the research subjects,and their clinical data were retrospectively analyzed.All patients were confirmed to have adrenal incidental tumors by surgical pathology.CT plain scan and spectral CT scan were carried out,and the detection results were analyzed.Results Compared with patients with adrenal adenoma,there were significant differences(P<0.05)in the number of cases of cystic degeneration,tumor size,uniform enhancement in the portal phase,and plain CT value(P<0.05)in the arterial phase of adrenal adenoma Compared with the CT value of 40-140KeV single energy and adrenal pheochromocytoma,the CT value of 70-140KeV single energy in the portal phase of adrenal adenoma was significantly different from that of adrenal pheochromocytoma(P<0.05).The NIC in the arterial phase and portal phase was significantly lower than that in adrenal chromaffin cells(P<0.05).The NHIC in arterial phase of adrenal adenoma was significantly lower than that of adrenal chromaffin cells(P<0.05).Adrenal adenoma portal phase NHIC and adrenal pheochromocytoma no significant difference(P>0.05).The area of the ROC curve for the differential diagnosis of adrenal adenoma and adrenal pheochromocytoma in arterial phase NIC was the largest,more than that in portal venous phase NIC and arterial phase NHIC.The sensitivity and specificity of NIC in arterial phase were higher than NIC in portal venous phase and NHIC in arterial phase.The accuracy of NIC in arterial phase was higher than NIC in portal venous phase and NHIC in arterial phase.Conclusion Spectral CT radiomics features have a significant role in the differential diagnosis of adrenal adenoma and adrenal pheochromocytoma in adrenal incidentaloma,while the sensitivity,specificity and accuracy of arterial phase NIC are higher.

关 键 词：能谱CT 肾上腺意外瘤 肾上腺腺瘤 肾上腺嗜铬细胞瘤 

分 类 号：R736.6[医药卫生—肿瘤]