摘要
目的:探讨宝石能谱CT多参数成像(gemstone spectral CT multi-parameter imaging)在肝脏肿瘤鉴别诊断、术前分期应用价值。方法:回顾性选择92例疑似肝脏恶性肿瘤患者,所有患者均行GSI扫描,获得定量参数(能谱曲线斜率(s-SHC)、动脉期标准碘浓度值(NIC)、门静脉期NIC、碘浓度差值(ICD)、肝动脉碘分数(AIF),以病理诊断结果为准,ROC分析s-SHC、动脉期NIC、门静脉期NIC、AIF值对肝癌的鉴别价值。Kappa一致性检验GSI对肝癌术前分期与病理诊断结果的一致性。结果:本组肝癌54例(恶性组),肝脏良性病变38例(良性组),恶性组s-SHC[(1.93±0.62)VS(0.85±0.36)]、动脉期NIC[(0.13±0.05)VS(0.06±0.02)]、门静脉期NIC[(0.47±0.14)VS(0.40±0.13)]、AIF[(0.65±0.19)VS(0.31±0.12)]高于良性组(P<0.05),ICD[(7.15±2.39)×102μg/cm3 VS(11.82±3.56)×102μg/cm3]低于良性组(P<0.05)。s-SHC、动脉期NIC诊断肝癌的效能较高,AUC分别为0.830和0.719,AIF无诊断价值。GSI诊断肝癌术前分期准确率77.78%,与病理诊断一致性较好(Kappa值=0.612,P<0.05))。结论:GSI参数s-SHC、动脉期NIC在肝脏肿瘤鉴别诊断中具有较高应用价值,GSI技术可准确对肝癌进行术前分期,为临床手术治疗提供可靠依据。
Objective:To investigate the value of gemstone energy spectrum CT(GSI)multi-parameter imaging in differential diagnosis and preoperative staging of liver tumors.Methods:Ninety-two patients with suspected hepatic malignant tumors were retrospectively selected.All patients underwent GSI scanning.Quantitative parameters[slope of energy spectrum curve(s-SHC),standard iodine concentration(NIC),portal phase NIC,iodine concentration difference(ICD),and hepatic artery iodine fraction(AIF)]were obtained.The differential value of s-SHC,arterial phase NIC,portal venous phase NIC and AIF for hepatocellular carcinoma was analyzed by ROC Value.Kappa consistency test was used to test the consistency of GSI in preoperative staging and pathological diagnosis of hepatocellular carcinoma.Results:54 patients with liver cancer(malignant group),38 with benign liver lesions(benign group),malignant group s-SHC[(1.93±0.62)vs(0.85±0.36)],arterial phase NIC[(0.13±0.05)vs(0.06±0.02)],portal NIC[(0.47±0.14)vs(0.40±0.13)],AIF[(0.65±0.19)vs(0.31±0.12)]were higher than benign group(P<0.05),ICD[(7.15±2.39)×102μg/cm3 vs(11.82±3.56)×102μg/cm3]was lower than the benign group(P<0.05).The efficacy of s-SHC and arterial phase NIC in the diagnosis of liver cancer was higher.The AUC was 0.830 and 0.719,respectively.AIF had no diagnostic value.The preoperative staging accuracy rate of GSI for diagnosis of liver cancer was 77.78%,which was consistent with pathological diagnosis(Kappa value=0.612,P<0.05).Conclusion:GSI parameters s-SHC and arterial NIC have high application value in differential diagnosis of hepatic tumors.GSI technology can accurately staging hepatocellular carcinoma before operation and provide reliable guidance for clinical surgical treatment.
作者
周永
周诚
甘晓晶
余莹莹
杨帆
文智
ZHOU Yong;ZHOU Cheng;GAN Xiaojing;YU Yingying;YANG Fan;WEN Zhi(Third Clinical Medical College of Xinjiang Medical University(Affiliated Tumor Hospital),Urumqi 830011,China)
出处
《CT理论与应用研究（中英文）》
2019年第5期601-607,共7页
Computerized Tomography Theory and Applications
基金
新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目（WJWY-201965）
关键词
宝石能谱CT
肝脏肿瘤
术前分期
gemstone energy spectrum CT
liver neoplasms
preoperative staging
