CT直方图分析对肾上腺乏脂性腺瘤的定性诊断价值

发布时间：2018-05-24 12:56

本文选题：肾上腺 + 腺瘤　；参考：《天津医科大学》2013年硕士论文

【摘要】：目的：探讨CT直方图分析的负值像素百分比对平扫CT值大于10HU的肾上腺乏脂腺瘤与非腺瘤的鉴别诊断价值。材料和方法：回顾性分析经手术病理证实或随访一年以上的192个肾上腺肿瘤,其中97个为平扫CT值小于10HU富脂性腺瘤,47个为平扫CT值大于10HU乏脂性腺瘤,48个为非腺瘤。测量每个富脂性腺瘤、乏脂性腺瘤与非腺瘤平扫CT值和经CT直方图分析测得的负值百分比并比较其间差异,对CT密度测量法与直方图分析对于乏脂性腺瘤的敏感性和特异性进行对照分析。并利用受试者操作曲线(receiver operating characteristic curve, ROC曲线)选择鉴别乏脂性腺瘤与非腺瘤的最合适阈值,同时评估乏脂性腺瘤的平扫CT值与负值像素百分比的关系。结果：100%的富脂性腺瘤、约82%的乏脂性腺瘤及0.02%的非腺瘤的负值百分比大于10%。乏脂性腺瘤平扫CT值(24.90±9.58HU)与非腺瘤平扫CT值(35.48±8.37HU)无显著差异(P0.05),乏脂性腺瘤的负值像素百分比(19.49±10.31%)高于非腺瘤(1.89±2.23%),二者具有显著性差异(P=0.000)。31个平扫CT值位于10HU-30HU的乏脂性腺瘤负值像素百分比全部大于10%,而15个平扫CT值大于30HU的乏脂性腺瘤只有8个(53.33%)的负值百分比大于10%。当负值像素百分比取15%时,诊断乏脂性腺瘤的敏感性为61.7%,特异性为100%；负值像素百分比取10%时诊断乏脂性腺瘤的敏感性增加到80.9%,特异性为97.9%；而负值像素百分比取5%,诊断乏脂性腺瘤的敏感性增加95.7%,特异性降到93.7%。而平扫CT值小于10HU,得出诊断腺瘤的敏感性为67%,特异性为100%。结论：CT直方图分析可提高平扫CT对乏脂性腺瘤的诊断准确性,对平扫CT值为10-30HU之间的乏脂性腺瘤的诊断效能最高。
[Abstract]:Objective: To explore the value of CT histogram analysis in the differential diagnosis of adrenal fat and non adenoma with plain scan CT value greater than 10HU.
Materials and methods: retrospective analysis of 192 adrenal tumors confirmed by surgical pathology or more than one year, of which 97 were plain scan CT value less than 10HU rich adenoma, 47 for plain scan CT value greater than 10HU adenoma, 48 non adenoma. Measurement of every fat adenoma, non fat adenoma and non adenoma CT value and CT histogram The sensitivity and specificity of CT density measurement and histogram analysis were compared and the sensitivity and specificity of histogram analysis and histogram analysis were compared. And the most suitable threshold of non lipomatous adenomas and non adenomas was selected by using the receiver operating characteristic curve (ROC curve). The relationship between the plain CT value and the percentage of negative pixel was evaluated.
Results: 100% of the fat rich adenomas, about 82% of the adenoma and 0.02% of non adenoma, were higher than that of 10%. (24.90 + 9.58HU) and non adenoma (35.48 + 8.37HU). The negative pixel percentile ratio (19.49 + 10.31%) of the adenoma was higher than that of non adenoma (19.49 + 10.31%) (1.89 + 2.23%). Two There was a significant difference (P=0.000) the percentage of negative pixels in the 10HU-30HU adenoma at 10HU-30HU was more than 10% in 10HU-30HU, but only 8 (53.33%) of 15 plain scan CT values greater than 30HU were greater than 10%. when the percentage of negative pixels was 15%, the sensitivity of the diagnosed adenoma was 61.7%, and the specificity was 100%. The sensitivity of the negative pixel percentage 10% was increased to 80.9%, the specificity was 97.9%, the percentage of the negative pixel was 5%, the sensitivity of the diagnosed adenoma increased by 95.7%, the specificity dropped to 93.7%. and the CT value was less than 10HU, and the sensitivity of the diagnosis of adenoma was 67% and the specificity was 100%..
Conclusion: CT histogram analysis can improve the diagnostic accuracy of plain scan CT for the diagnosis of fat - wasting adenoma, and has the highest diagnostic efficiency for the patients with fat - wasting adenoma with a CT value of 10-30HU.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R816.7;R736.6

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