双源双能量CT定量参数联合血清AFP、GGT/ALT在鉴别诊断肝脏良恶性肿瘤中的价值  

Value of quantitative parameters of dual-source dual-energy CT combined with serum AFP and GGT/ALT in the differential diagnosis of benign and malignant liver tumors

作　　者：谷祥荣 董秋杰 田红斌 刘衡 张伟国 GU Xiangrong;DONG Qiujie;TIAN Hongbin;LIU Heng;ZHANG Weiguo(Department of Radiology,Daping Hospital,Army Military Medical University,Chongqing 400042,China;Chongqing Clinical Research Centre of Imaging and Nuclear Medicine,Chongqing 400042,China;Department of Nuclear Medicine,Daping Hospital,Army Military Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院放射科,重庆400042 [2]重庆市影像学与核医学临床研究中心,重庆400042 [3]陆军军医大学大坪医院核医学科,重庆400042

出　　处：《检验医学与临床》2025年第6期732-736,共5页Laboratory Medicine and Clinic

基　　金：重庆市影像医学与核医学临床研究中心科技计划项目(CSTC2015YFPT-gcjsyjzx0175)。

摘　　要：目的探讨双源双能量CT定量参数联合血清甲胎蛋白(AFP)、γ-谷氨酰转移酶与丙氨酸转氨酶比值(GGT/ALT)在鉴别诊断肝脏良恶性肿瘤中的价值。方法回顾性收集2023年6月至2024年9月在大坪医院通过双源双能量CT行腹部增强扫描且肝脏有肿瘤性病变的患者76例作为研究对象,根据病理结果将其分为恶性组和良性组,每组38例。比较2组双源双能量CT定量参数[动、静脉期的电子云密度(Rho)、有效原子序数(Zeff)]、AFP、GGT/ALT的差异;绘制受试者工作特征(ROC)曲线分析双源双能量CT定量参数、AFP、GGT/ALT单独以及联合鉴别诊断肝脏良恶性肿瘤的价值。结果恶性组的动、静脉期的Rho、Zeff均低于良性组,差异均有统计学意义(P<0.05)。恶性组的AFP水平、GGT/ALT高于良性组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,动脉期Rho、静脉期Rho、动脉期Zeff、静脉期Zeff与AFP、GGT/ALT联合鉴别诊断肝脏良恶性肿瘤的曲线下面积(AUC)为0.965,优于各指标单独鉴别诊断的AUC(P<0.05)。结论双源双能量CT定量参数、血清AFP、GGT/ALT在鉴别诊断肝脏良恶性肿瘤中具有一定临床价值,且联合鉴别诊断肝脏良恶性肿瘤的效能优于单一指标。Objective To investigate the value of quantitative parameters of dual-source dual-energy CT combined with serum alpha-fetoprotein(AFP)and the ratio of gamma-glutamyl transpeptidase to alanine aminotransferase(GGT/ALT)in t he differential diagnosis of benign and malignant liver tumors.Methods Seventy-six patients who underwent abdominal enhancement scanning by dual-source dual-energy CT and had neoplastic lesions in the liver were retrospectively collected from June 2023 to September 2024 at Daping Hospital as the study subjects,which were divided into malignant group and benign group according to the pathological results,with 38 cases in each group.The quantitative parameters of dual-source dual-energy CT[specifically electron cloud density(Rho)and effective atomic number(Zeff)during both arterial and venous phases],as well as AFP and GGT/ALT between the two groups were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the value of quantitative parameters of dual-source dual-energy CT,AFP,GGT/ALT alone and in combination in the differential diagnosis of benign and malignant liver tumors.Results The Rho and Zeff values in the arterial and venous phases of the malignant group were lower than those of the benign group,and the differences were statistically significant(P<0.05).The levels of AFP and GGT/ALT in the malignant group were higher than those in the benign group,and the differences were statistically significant(P<0.05).The ROC curve results indicated that the area under the curve(AUC)for the differential diagnosis of benign and malignant liver tumors by arterial phase Rho,venous phase Rho,arterial phase Zeff,venous phase Zeff,and AFP,GGT/ALT was 0.965,which was superior to the AUC of each individual index for differential diagnosis(P<0.05).Conclusion The quantitative parameters of dual-source dual-energy CT,serum AFP and GGT/ALT have certain clinical value in the differential diagnosis of benign and malignant liver tumors,and the combined differential diagnosis of benign and mali

关 键 词：双源双能量CT 甲胎蛋白 肝脏肿瘤 良性 恶性 鉴别诊断 

分 类 号：R445.3[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]