基于CT增强直方图分析鉴别腮腺多形性腺瘤与基底细胞腺瘤  

Differential diagnosis between parotid pleomorphic adenoma and basal cell adenoma based on CT enhanced histogram analysis

作　　者：韩蕾[1] 马鸣岳[1] 董燕[1] 刘红生[1] 孙鹏峰 张巧莹 高明[1] 刘晓岚 邬小平[1] HAN Lei;MA Ming-yue;DONG Yan;LIU Hong-sheng;SUN Peng-feng;ZHANG Qiao-ying;GAO Ming;LIU Xiao-lan;WU Xiao-ping(Department of Radiology,Xi'an Central Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710003,China)

机构地区：[1]西安交通大学附属西安市中心医院放射科,陕西西安710003

出　　处：《中国临床医学影像杂志》2025年第2期90-94,共5页Journal of China Clinic Medical Imaging

基　　金：陕西省自然科学基金项目(2022JQ-933);陕西省重点研发计划一般项目(2023-YBSF-673)。

摘　　要：目的:探讨基于CT增强直方图参数鉴别腮腺多形性腺瘤(PA)与基底细胞腺瘤(BCA)的应用价值。方法:回顾性分析2017年1月—2023年12月我院经手术病理证实的55例PA与35例BCA患者的临床及影像学资料,所有患者均行常规CT平扫及双期CT增强扫描,运用Fire Voxel软件对肿瘤实质全域勾画并进行直方图分析,获得相应的直方图参数(平均值、变异度、偏度、峰度及第1、10、50、90、99百分位数)。比较腮腺PA与BCA组间各直方图参数的差异,运用受试者工作特征曲线评估直方图参数对PA与BCA的鉴别诊断效能。结果:(1)BCA组在平扫第1百分位数、动脉期平均值、动脉期变异度、动脉期第10、50、90、99百分位数、静脉期平均值均显著大于PA组,差异具有统计学意义(P<0.05)。(2)受试者工作特征曲线显示,在平扫、动脉期及静脉期直方图参数比较中,动脉期直方图参数显示出更优的诊断效能;其中,动脉期第90百分位数具有最优的鉴别诊断效能,当截断值为132.00×10-6mm2/s时,曲线下面积为0.876;此时,鉴别PA与BCA的敏感度、特异度分别为90.50%、84.00%。结论:基于CT增强直方图分析对鉴别PA与BCA具有一定价值。Objective:To explore the application value of differentiating pleomorphic adenoma(PA)from basal cell adenoma(BCA),BCA based on CT enhanced histogram parameters.Methods:Retrospective analysis of clinical and imaging data from 55 patients with PA and 35 patients with BCA confirmed by surgery and pathology in our hospital from January 2017 to December 2023.All patients underwent routine CT plain scan and biphasic CT enhanced scan.FireVoxel software was used to delineate the entire tumor parenchyma and perform histogram analysis to obtain corresponding histogram parameters(mean,variability,skewness,kurtosis,and 1st,10th,50th,90th,and 99th percentiles).To compare the differences of histogram parameters between PA and BCA in parotid gland,and to evaluate the differential diagnostic efficiency of histogram parameters between PA and BCA by receiver operating characteristic(ROC)curve.Results:(1)The 1st percentile of plain scan,mean arterial phase,arterial phase variability,10th,50th,90th and 99th percentile of arterial phase and mean venous phase in BCA group were significantly higher than those in PA group,and the difference was statistically significant(P<0.05).(2)ROC curve showed that the arterial phase histogram parameters showed better diagnostic efficiency among plain scan,arterial phase histogram parameters and venous phase histogram parameters.Among them,the 90th percentile in arterial phase has the best differential diagnosis efficiency.When the cutoff value is 132.00×10~(-6)mm~2/s,the area under the curve is 0.876.At this time,the sensitivity and specificity of distinguishing PA from BCA are 90.50%and 84.00%,respectively.Conclusion:CT enhanced histogram analysis has certain value in distinguishing PA from BCA.

关 键 词：腮腺肿瘤 腺瘤 体层摄影术 X线计算机 

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