光谱CT定量增强参数对肾细胞癌与肾血管平滑肌脂肪瘤的诊断价值  

Diagnostic value multimodal parameter imaging based on spectral CT in differentiating renal cell carcinoma from renal angiomyolipoma

作　　者：席晓旭 陈志晔[1] XI Xiaoxu;CHEN Zhiye(Department of Radiology,Hainan Hospital of PLA General Hospital,Sanya 572013,China)

机构地区：[1]解放军总医院海南医院放射诊断科,海南三亚572013

出　　处：《分子影像学杂志》2025年第2期218-222,共5页Journal of Molecular Imaging

摘　　要：目的探讨光谱CT定量增强参数动脉增强分数(AEF)和细胞外容积(ECV)在肾细胞癌(RCC)与肾血管平滑肌脂肪瘤(RAML)鉴别中的诊断价值。方法对2021年1月~2024年5月于解放军总医院海南医院放射诊断科行肾脏光谱CT三期增强的RCC患者(n=27)及肾血管平滑肌脂肪瘤患者(n=27)的能谱基数据进行处理,生成AEF图及ECV图,分别测量肿瘤及对侧正常肾脏皮质的AEF及ECV值。采用独立样本t检验及Mann-Whitney U检验进行组间比较,采用ROC曲线评价其诊断效能。结果RCC的AEF及ECV值大于RAML的AEF及ECV值(P_(AEF)<0.0001,P_(ECV)<0.0001),RCC的AEF值与对侧正常肾脏皮质的AEF值的差异无统计学意义(P=0.406),RCC的ECV值小于对侧正常肾脏皮质的ECV值(P<0.0001),RAML的AEF及ECV值均小于对侧正常肾脏皮质的AEF值(P_(AEF)<0.0001,P_(ECV)<0.0001)。AEF、ECV值诊断RCC的曲线下面积分别为0.566、0.992,AEF敏感度为37.1%、特异度为85.2%,ECV敏感度为96.3%、特异度为100%;AEF、ECV值诊断RAML的ROC曲线下面积分别为0.818、1.000,AEF敏感度为77.8%、特异性为88.9%,ECV敏感度及特异度均为100%。结论光谱CT定量增强参数AEF及ECV不仅可检出RCC及RAML,且对于两者鉴别具有较高的诊断价值。Objective To investigate the diagnostic value of spectral CT quantitative enhancement parameters arterial enhancement fraction(AEF)and extracellular volume(ECV)in the differential diagnosis of renal cell carcinoma and renal angiomyolipoma.Methods The spectral base data of 54 patients with renal cell carcinoma and renal angiomyolipoma who underwent three-phase enhanced spectral CT in the Department of Radiology,Hainan Hospital of General Hospital of Chinese PLA from January 2021 to May 2024 were analyzed.The arterial enhancement fraction(AEF)map and extracellular volume(ECV)map were generated,the AEF and ECV values of tumor and contralateral normal renal cortex were measured respectively.The independent sample t test and Mann-Whitney U test were applied for inter-group comparisons,and ROC curve was used to evaluate the diagnostic efficacy.Results The AEF and ECV values of RCC were presented significantly more highly than those of RAML(P_(AEF)<0.0001,P_(ECV)<0.0001).There was no significant difference in AEF value between RCC and contralateral normal kidney cortex(P=0.406).The ECV value of RCC was significantly lower than that of contralateral normal kidney cortex(P<0.0001).The AEF and ECV values of RAML were lower than those of contralateral normal kidney cortex(P_(AEF)<0.0001,P_(ECV)<0.0001).The area under the ROC curve of AEF and ECV in the diagnosis of RCC was 0.566 and 0.992.The sensitivity and specificity of AEF were 37.1% and 85.2%.The sensitivity and specificity of ECV were 96.3% and 100%.The area under the ROC curve of AEF and ECV in the diagnosis of RAML was 0.818 and 1.000.The sensitivity and specificity of AEF were 77.8% and 88.9%.The sensitivity and specificity of ECV were both 100%.Conclusion Spectral CT quantitative enhancement parameters AEF and ECV can not only detect renal cell carcinoma and renal angiomyolipoma,but also have high diagnostic value for the identification of them.

关 键 词：动脉增强分类 细胞外容积 肾细胞癌 肾血管平滑肌脂肪瘤 光谱CT 

分 类 号：R737.11[医药卫生—肿瘤] R730.44[医药卫生—临床医学]