摘要
目的分析鉴别低危胸腺瘤和高危胸腺瘤能谱CT成像的定量参数特征性改变。方法回顾性分析2017年5月—2019年12月经病理证实的23例低危胸腺瘤和17例高危胸腺瘤患者,术前均行双期能谱CT增强扫描,通过获得不同单能量下的CT值和碘(水)浓度值对其进行定量分析,并对其形态学进行定性分析。结果在动脉期,低危胸腺瘤40~70 keV单能量CT值和碘浓度值均低于高危胸腺瘤,差异均有统计学意义(均P<0.05);在静脉期,高危胸腺瘤40~100keV单能量CT值和碘基值均高于低危胸腺瘤,差异均有统计学意义(均P<0.05);双期扫描中,低危和高危胸腺瘤水基值差异均无统计学意义(均P>0.05)。ROC曲线分析显示静脉期40keV下CT值对鉴别低危胸腺瘤与高危胸腺瘤有较高的灵敏度(75.4%)与特异度(66.7%)。二组病变的边缘、形态、钙化情况、大血管、心包和胸膜侵袭方面差异均有统计学意义(均P<0.05),高危胸腺瘤均高于低危胸腺瘤。结论能谱CT成像对低危和高危胸腺瘤均有一定的鉴别诊断价值,对临床有指导意义。
Objective To analyze the characteristic changes of quantitative parameters of spectrum CT imaging in differentiating low-risk thymoma and high-risk thymoma.Methods Retrospective analysis was performed in twenty-three patients with low-risk thymoma and 17 patients with high-risk thymoma from May 2017 to December 2019,all pathologically confirmed.All the patients underwent two phases enhanced spectral CT scan prior to surgery.All spectrum imaging data were quantitatively analyzed with GSI viewer to obtain CT value and iodine(water)concentration on different monochromatic images,and the morphological featureswere qualitative evaluated.Results The CT values on 40-70 keV monochromatic images and iodine concentration were lower in low-risk thymoma than those in high-risk thymoma in arterial phases,the difference was statistically significant(P<0.05);The CT values on 40-100 keV monochromatic images and iodine concentration were higher in high-risk thymoma than those in low-risk thymoma in venous phases,the difference was statistically significant(P<0.05);There was no significant difference in water concentration between low-risk and high-risk thymomas in the two-phase scan(P>0.05).There were statistically significant differences in the edge,morphology,calcification,and invasion of the great vessels,pericardium and pleura between the two groups(P<0.05),and those features of high-risk thymoma were higher than that of the low-risk thymoma.ROC curve analysis showed that the CT value on 40 keV monochromatic image in venous phase was sensitive in differential diagnosis of low-risk thymoma and high-risk thymoma with sensitivity(75.4%)and specificity(66.7%).Conclusion Energy spectrum CT has certain values in differential diagnosis of low-risk thymoma and high-risk thymoma,and has guiding significance in clinic.
作者
曹立秀
李会菊
马拓
陈大鹏
任红亮
李志东
高媛
Cao Lixiu;Li Huiju;Ma Tuo(Tangshan People′s Hospital,Tangshan 063000,China)
出处
《中国煤炭工业医学杂志》
2020年第5期481-486,共6页
Chinese Journal of Coal Industry Medicine
基金
2019年度河北省医学科学研究重点课题计划(编号:20191622)。
关键词
能谱CT成像
低危胸腺瘤
高危胸腺瘤
Energy spectrum CT imaging
Low risk thymoma
High risk thymoma
