| 刘静红,刘爱连,田士峰,汪禾青,马春梅,鞠烨,孙博.能谱CT碘含量定量分析乏脂性肾血管平滑肌脂肪瘤与透明细胞癌[J].中国医学影像技术,2013,29(11):1878~1881 |
| 能谱CT碘含量定量分析乏脂性肾血管平滑肌脂肪瘤与透明细胞癌 |
| Spectral CT-based quantitative analysis of iodine content for differentiating angiomyolipoma with minimal fat and clear cell renal cell carcinoma |
| 投稿时间：2013-06-01 修订日期：2013-08-23 |
| DOI： |
| 中文关键词: 癌,肾细胞 血管平滑肌脂肪瘤 体层摄影术,X线计算机 能谱成像 |
| 英文关键词:Carcinoma, renal cell Angiomyolipoma Tomography, X-ray computed Gemstone imaging |
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| 中文摘要: |
| 目的 评价能谱CT碘含量对乏脂性肾血管平滑肌脂肪瘤(AML)与肾透明细胞癌(CCRCC)的鉴别诊断价值。方法 选取在我院接受能谱CT扫描且经手术病理证实的肾脏实性肿块患者27例,其中CCRCC 20例,乏脂性AML 7例,直径均≤3.0 cm。使用GE Discovery HD 750能谱CT机,采用能谱扫描模式进行三期动态增强扫描。利用GSI Viewer分析软件生成碘水密度图,记录肿瘤最大层面的绝对碘水密度值和相对碘水密度值。采用独立样本t检验分析两种病变各期相的绝对碘水密度值、相对碘水密度值的差异;绘制ROC曲线,分析各期碘水密度值的诊断效能。结果 三期扫描中,CCRCC的相对碘水密度值均高于乏脂性AML(P均<0.05)。皮质期、髓质期及延迟期相对碘水密度值的曲线下面积分别为0.779、0.943及0.900。皮质期、髓质期及延迟期相对碘水密度值阈值分别为42.98(100 μg/cm3)、68.01(100 μg/cm3)、72.09(100 μg/cm3),诊断AML与CCRCC的敏感度和特异度分别为55.0%、100%,85.0%、100%,75.0%、85.7%。结论 应用能谱CT增强扫描,以髓质期相对碘水密度值68.01(100 μg/cm3)作为诊断阈值,可以很好地区分乏脂性AML与CCRCC。 |
| 英文摘要: |
| Objective To evaluate the differential diagnostic value of iodine content based spectral CT for renal angiomyolipoma (AML) with minimal fat and clear cell renal cell carcinoma (CCRCC). Methods Twenty-seven patients with small solid renal masses, including 20 cases of CCRCC and 7 cases of renal AML with minimal fat confirmed with pathology were scanned with spectral CT. The diameter of each tumor was not more than 3 cm. All patients underwent three-phase enhance spectral CT imaging using GE Discovery CT750 HD, the iodine-based material decomposition images were reconstructed with gemstone imaging Viewer, and absolute and normalized iodine concentrations for renal lesions were obtained. All results were analyzed statistically with independent-samples t test. The diagnostic performances were evaluated using ROC analysis. Results Normalized iodine concentrations of CCRCC were higher than that of renal AML with minimal fat in all three phases (P<0.05). According to ROC, area under curve of normalized iodine concentration was 0.779, 0.943 and 0.900 in the cortex phase, corticomedullary phase and equilibrium phase, respectively. Taking normalized iodine concentration 42.98 (100 μg/cm3), 68.01 (100 μg/cm3) and 72.09 (100 μg/cm3) as threshold values of the cortex phase, corticomedullary phase and equilibrium phase, the sensitivity and specificity was 55.0% and 100%, 85.0% and 100%, 75.0% and 85.7%, respectively. Conclusion Taking normalized iodine concentration 68.01 (100 μg/cm3) as threshold value in the corticomedullary phase can help to differential diagnosis of CCRCC and renal AML with minimal fat. |
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