基于CT及临床指标构建的模型鉴别腮腺基底细胞腺瘤和多形性腺瘤的价值  

Analysis of the value of the model based on CT and clinical indicators in differentiating parotid basal cell adenoma from pleomorphic adenoma

作　　者：路丽 柳成良 左超 于淑靖[1] LU Li;LIU Chengliang;ZUO Chao;YU Shujing(Department of CT Diagnosis,Cangzhou Central Hospital in Hebei Province,Cangzhou 061000,China;Department of Ultrasound,Cangzhou Central Hospital,Hebei Province,Cangzhou 061000,China;Department of Nuclear Medicine,Cangzhou Central Hospital,Hebei Province,Cangzhou 061000,China)

机构地区：[1]河北省沧州市中心医院CT诊断科,河北沧州061000 [2]河北省沧州市中心医院超声二科,河北沧州061000 [3]河北省沧州市中心医院核医学科,河北沧州061000

出　　处：《医学影像学杂志》2024年第9期24-27,共4页Journal of Medical Imaging

基　　金：河北省医学科学研究课题计划项目(编号:20220378)。

摘　　要：目的探讨双期增强CT及临床指标构建的模型对腮腺基底细胞腺瘤(BCA)和多形性腺瘤(PA)的鉴别价值。方法选取我院经手术病理证实的BCA和PA患者95例,其中BCA患者18例为BCA组,PA患者77例为PA组,比较两组CT平扫及双期增强表现、临床资料,基于双期增强CT及临床资料构建BCA和PA的鉴别模型。结果BCA组平扫CT值与PA组比较,差异无统计学意义(P>0.05),BCA组动脉期强化幅度值、静脉期强化幅度值与PA组比较,明显较高,差异有统计学意义(P<0.05)。BCA组病程、肿瘤最大直径、性别、部位、位置、密度、形态、边界、同侧肿瘤淋巴结、吸烟史、饮酒史比较,差异均无统计学意义(P>0.05),BCA组年龄≥50岁率、触诊较软率与PA组比较明显较高,差异有统计学意义(P<0.05)。Hosmer-Lemeshow拟合度检验显示模型拟合优度较好(χ^(2)=0.379,P=1.000)。ROC分析显示双期增强CT及临床指标联合构建的模型,鉴别诊断腮腺BCA和PA的AUC为0.966,约登指数为0.931,敏感度、特异度分别为94.4%、98.7%(95%CI 0.902~1.000),准确性为97.89%。结论基于双期增强CT及临床资料构建的BCA和PA鉴别模型效果较好,能够为BCA和PA鉴别提供辅助参考。Objective To investigate the value of dual-phase enhanced CT and clinical index model in differentiating parotid basal cell adenoma(BCA)and pleomorphic adenoma(PA).Methods 95 patients with BCA and PA confirmed by surgery and pathology were selected,of whom 18 patients with BCA were included in the BCA group and 77 patients with PA were included in the PA group.CT plain scan and dual-phase enhanced findings and clinical data of the two groups were compared.The differential model of BCA and PA was established based on two-phase enhanced CT and clinical data.Results There was no statistical significance in plain scan CT value of BCA group compared with PA group(P>0.05),but the enhancement amplitude of arterial phase and venous phase in BCA group were significantly higher than those in PA group(P<0.05).There was no statistical significance in the course of disease,maximum tumor diameter,gender,location,location,density,shape,boundary,ipsilateral tumor lymph nodes,smoking history,and drinking history in BCA group(P>0.05).The rate of age≥50 and soft palpation in BCA group were significantly higher than those in PA group(P<0.05).The Hosmer-Lemeshow fit test showed that the model had a good fit(χ^(2)=0.379,P=1.000).ROC analysis showed that the AUC for the differential diagnosis of BCA and PA in a models constructed by combining biphasic enhanced CT and clinical indicators was 0.966,the Yoden index was 0.931,the sensitivity and specificity were 94.4%and 98.7%,the 95%CI was(0.902~1.000),and the accuracy was 97.89%.Conclusion The identification model of BCA and PA based on dual-phase enhanced CT and clinical data is effective,whcih can provide auxiliary reference for the identification of BCA and PA.

关 键 词：腮腺基底细胞腺瘤 多形性腺瘤 体层摄影术 X线计算机 诊断 

分 类 号：R739.87[医药卫生—肿瘤] R814.42[医药卫生—临床医学]