能谱CT定量分析鉴别诊断肾透明细胞癌与肾脏乏脂肪血管平滑肌脂肪瘤的临床应用

发布时间：2018-06-11 21:54

  本文选题：能谱成像 + 体层摄影术　； 参考：《临床军医杂志》2016年09期

【摘要】：目的探讨能谱CT定量分析鉴别诊断肾透明细胞癌(ccRCC)和肾脏乏脂肪血管平滑肌脂肪瘤(RAML)的临床价值,以指导临床治疗方案的选择。方法回顾性分析术前行肾脏平扫+能谱CT双期增强扫描并经手术病理证实的38例ccRCC与9例乏脂肪RAML患者的临床资料。应用能谱分析软件,测量并计算皮、髓质期病灶实性部分的碘浓度(IC)、标准化碘浓度(NIC)、能谱曲线斜率及40~140 keV下的CT值,应用独立样本t检验,对两组病变各参数值进行比较,绘制ROC曲线,分析IC、NIC、能谱曲线斜率的诊断效能。结果 ccRCC皮质期IC(62.20±19.50)μg/ml、NIC(0.48±0.13)μg/ml分别高于乏脂肪RAML皮质期IC(35.82±18.40)μg/ml、NIC(0.26±0.12)μg/ml(P0.05)。ccRCC皮质期曲线斜率(8.66±2.53)、髓质期曲线斜率(4.86±1.17)分别大于乏脂肪RAML皮质期曲线斜率(4.87±2.50)、髓质期曲线斜率(3.32±1.30)(P0.05)。ccRCC皮质期40~100 keV、髓质期40~60 keV下的CT值分别高于乏脂肪RAML皮质期40~100 keV、髓质期40~60 keV下的CT值(P0.05)。以皮质期与髓质期IC分别52.14μg/ml与27.76μg/ml、NIC分别0.39与0.69、曲线斜率分别6.35与3.76为阈值诊断,ccRCC的敏感度分别为70.6%与85.3%、73.5%与91.2%、85.3%与85.3%,特异度分别为87.5%与75.0%、100.0%与75.0%、75.0%与75.0%。结论能谱CT成像及多参数定量分析对ccRCC与乏脂肪RAML的鉴别诊断有一定临床应用价值,有望为术前治疗方案的选择提供依据。
[Abstract]:Objective to evaluate the clinical value of quantitative analysis of energy dispersive CT in the differential diagnosis of renal clear cell carcinoma (CCRCC) and renal adipose angiomyolipoma (RML) in order to guide the choice of clinical treatment. Methods the clinical data of 38 patients with CCRCC and 9 patients with adipose raML confirmed by surgery and pathology were retrospectively analyzed. Using the software of energy spectrum analysis, we measured and calculated the iodine concentration of the solid part of the lesion in the skin and medullary phase, the standard iodine concentration, the slope of the energy spectrum curve and the CT value at 40 ~ 140keV. The parameters of the two groups were compared with each other by t-test. The ROC curve was drawn, and the diagnostic efficiency of the slope of ICNIC and energy spectrum curve was analyzed. 缁撴灉 ccRCC鐨�璐ㄦ湡IC(62.20卤19.50)渭g/ml,NIC(0.48卤0.13)渭g/ml鍒嗗埆楂樹簬涔忚剛鑲猂AML鐨�璐ㄦ湡IC(35.82卤18.40)渭g/ml,NIC(0.26卤0.12)渭g/ml(P0.05).ccRCC鐨�璐ㄦ湡鏇茬嚎鏂滅帲�

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