MDCT增强结合CTA多维技术术前评估颌面部软组织富血供肿瘤的价值  

Role of MDCT enhancement combined with multi-dimensional CTA in preoperative evaluation of hypervascular tumors in maxillofacial soft tissues

作　　者：武月华 张爽 王泽正 WU Yuehua;ZHANG Shuang;WANG Zezheng(Stomatological Hospital Affiliated to Medical School of Nanjing University/Nanjing Stomatological Hospital/Institute of Stomatology of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属口腔医院/南京市口腔医院/南京大学口腔医学研究所,江苏南京210008

出　　处：《中国医学物理学杂志》2025年第3期320-323,共4页Chinese Journal of Medical Physics

基　　金：国家自然科学基金(82301103)。

摘　　要：目的:分析多排螺旋CT(MDCT)增强结合CT血管成像(CTA)多维技术术前评估颌面部软组织富血供肿瘤的价值。方法:选取86例口腔颌面部软组织肿瘤患者,以病理检查结果作为“金标准”,所有患者均进行MDCT增强结合CTA多维技术检查。采用Κappa检验分析该技术对肿瘤良恶性的诊断结果与病理检查结果的一致性,比较良恶性肿瘤血供情况(平扫CT值、动脉期CT值、静脉期CT值、动脉净强化CT值、静脉净强化CT值);采用ROC曲线分析不同脉管CT值对肿瘤性质的诊断价值。结果:86例口腔颌面部软组织肿瘤患者均经病理检查确诊,其中良性50例,恶性36例。该技术诊断口腔颌面部软组织恶性肿瘤34例,其中确诊32例,误诊2例,漏诊4例;该技术诊断肿瘤良恶性与病理结果的一致性为0.878。良性组动脉期CT值、静脉期CT值、动脉净强化CT值、静脉净强化CT值均低于恶性组(P<0.05)。ROC曲线分析结果显示,动脉期CT值(AUC=0.778)、静脉期CT值(AUC=0.745)、动脉净强化CT值(AUC=0.738)、静脉净强化CT值(AUC=0.781)对肿瘤性质具有良好的鉴别价值(P<0.05)。结论:MDCT增强结合CTA多维技术对术前评估颌面部软组织富血供肿瘤性质具有良好的指导价值。Objective To explore the value of the combination of multi-detector row helical CT(MDCT) enhancement and multi-dimensional CT angiography(CTA) in preoperative diagnosis of hypervascular tumors in maxillofacial soft tissues.Methods Eighty-six patients with oral and maxillofacial soft tissue tumors were enrolled and examined with MDCT enhancement combined with multi-dimensional CTA.Κappa test was used to analyze the consistency of the proposed technology with pathological examination as the gold standard for determining benign and malignant tumors.The blood supplies(CT values of plain scan,arterial phase,venous phase,arterial-phase net enhancement and venous-phase net enhancement) of benign and malignant tumors were compared.The diagnostic value of different vascular CT values for tumor properties was evaluated with ROC curves.Results Pathological examination identified 50 benign cases and 36malignant cases out of 86 patients with oral and maxillofacial soft tissue tumors.Thirty-four cases were diagnosed as malignant tumors when using MDCT enhancement combined with multi-dimensional CTA,and there were 32 confirmed cases,2 misdiagnosed cases and 4 missed cases.The consistency of the proposed technology with pathological examination for diagnosing benign and malignant tumors was 0.878.Benign group had lower CT values of arterial phase,venous phase,arterial-phase net enhancement and venous-phase net enhancement than malignant group(P<0.05).The results of ROC curves revealed that the CT values of arterial phase,venous phase,arterial-phase net enhancement and venous-phase net enhancement were of high differential diagnostic value in tumor properties(AUC=0.778,0.745,0.738 and 0.781,respectively;P<0.05).Conclusion The combination of MDCT enhancement and multi-dimensional CTA provides significant guidance for the diagnosis of hypervascular tumors in maxillofacial soft tissues.

关 键 词：多排螺旋CT CT血管成像多维技术 颌面部软组织 富血供肿瘤 

分 类 号：R816.98[医药卫生—放射医学]