冯瑶杰,吕艳娥,瞿姣,李青青,杨亚英,高洁.双能CT评估喉部鳞癌分化程度[J].中国医学影像技术,2021,37(7):1002~1006
双能CT评估喉部鳞癌分化程度
Dual-energy CT for evaluation on differentiation degrees of laryngeal squamous cell carcinoma
投稿时间:2020-07-02  修订日期:2021-05-10
DOI:10.13929/j.issn.1003-3289.2021.07.009
中文关键词:  喉肿瘤  细胞分化  病理学  体层摄影术,X线计算机  能谱成像
英文关键词:laryngeal neoplasms  cell differentiation  pathology  tomography, X-ray computed  spectral imaging
基金项目:
作者单位E-mail
冯瑶杰 昆明医科大学第一附属医院医学影像科, 云南 昆明 650032  
吕艳娥 昆明医科大学第一附属医院医学影像科, 云南 昆明 650032  
瞿姣 昆明医科大学第一附属医院医学影像科, 云南 昆明 650032  
李青青 昆明医科大学第一附属医院医学影像科, 云南 昆明 650032  
杨亚英 昆明医科大学第一附属医院医学影像科, 云南 昆明 650032 yayingyang@163.com 
高洁 昆明医科大学第一附属医院医学影像科, 云南 昆明 650032  
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中文摘要:
      目的 观察双能CT定量参数评估喉部鳞癌分化程度的价值。方法 收集92例术前接受颈部双能CT并经手术病理证实的喉部鳞癌患者,比较不同分化程度肿瘤动脉期及静脉期碘浓度(IC)、标准化碘浓度(NIC)、碘图CT值(Overlay值)及能谱曲线斜率(λHU)的差异。针对差异有统计学意义的参数绘制其鉴别不同分化程度肿瘤的受试者工作特征(ROC)曲线,评估其诊断效能;分析各定量参数与肿瘤分化程度的相关性。结果 92例中,31例高分化鳞癌,38例中分化鳞癌,23例低分化鳞癌。低分化鳞癌动脉期、静脉期各定量参数均高于高分化及中分化鳞癌(P均<0.05);中分化鳞癌静脉期λHU高于高分化鳞癌(P<0.05)。动脉期、静脉期IC、NIC、Overlay值及λHU均与肿瘤分化程度呈负相关(动脉期rs分别为-0.51、-0.31、-0.35、-0.46,静脉期rs分别为-0.40、-0.27、-0.43,-0.49,P均<0.05)。ROC曲线显示,动脉期λHU鉴别高、低分化鳞癌以及中、低分化鳞癌的曲线下面积(AUC)最高,分别为0.87、0.78,敏感度分别为73.90%、73.90%,特异度分别为96.80%、76.30%;静脉期λHU鉴别高、中分化鳞癌的AUC为0.69,敏感度及特异度分别为65.80%、71.00%。结论 双能CT定量参数对评估喉部鳞癌分化程度具有一定价值,以动脉期λHU鉴别低分化与中、高分化鳞癌的效能最高。
英文摘要:
      Objective To observe the value of dual-energy CT quantitative parameters in evaluating differentiation degree of laryngeal squamous cell carcinoma. Methods Preoperative neck dual-energy CT data of 92 patients with surgery and pathology confirmed laryngeal squamous cell carcinoma were retrospectively analyzed. The iodine concentration (IC), normalized iodine concentration (NIC), CT value of iodine graph (Overlay value) and the slope of spectral curve (λHU) in arterial phase and venous phase were compared among different differentiation degrees tumors. According to parameters being statistically different among differentiation degrees, the receiver operating characteristic (ROC) curves were drawn to evaluate the corresponding diagnostic efficacies. The correlations of quantitative parameters and the differentiation degrees of laryngeal squamous cell carcinomas were analyzed. Results There were 31 cases of high differentiated, 38 of moderate and 23 of poor differentiated tumors. All arterial and venous phases quantitative parameters of poor differentiated tumors were higher than those of high and moderately differentiated ones (all P<0.05), while λHU in venous phases of moderate differentiated tumors was higher than that in high differentiated ones (P<0.05). The IC, NIC, Overlay value and λHU in arterial phases and venous phases were negatively correlated with the differentiation degrees of tumors (rs=-0.51, -0.31, -0.35, -0.46 in arterial phases, -0.40, -0.27, -0.43, -0.49 in venous phases, respectively, all P<0.05).λHU in arterial phase was the best for distinguishing high from poor and moderate from poor differentiated tumors, with the area under the curve (AUC) of 0.87 and 0.78, sensitivity of 73.90% and 73.90%, specificity of 96.80% and 76.30%, respectively. AUC of λHU in venous phase was 0.69 for distinguishing high or moderate differentiated tumors, with sensitivity of 65.80% and specificity of 71.00%, respectively. Conclusion Quantitative parameters of dual-energy CT were valuable for predicting differentiation degrees laryngeal squamous cell carcinoma, and λHU in arterial phase had the highest diagnostic efficiency for distinguishing poor from moderate and high differentiated tumors.
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