摘要
目的:探讨Revolution CT灌注成像对肾上腺乏脂性腺瘤(简称腺瘤)与肺癌肾上腺转移瘤(简称转移瘤)的鉴别价值。方法:回顾性收集于我院接受肾上腺Revolution CT灌注扫描的患者资料,经手术病理证实的腺瘤(平扫CT值>10 HU)13例,经病理或影像随访证实的转移瘤7例共10个病灶。记录肿瘤的大小、平扫及增强扫描三期CT值;测量肿瘤的血流量(BF)、血容量(BV)、平均通过时间(MTT)、达峰时间(TP)及表面通透性(PS)。比较腺瘤组与转移瘤组各参数值的差异,采用ROC曲线分析CT灌注参数鉴别两者的效能。结果:腺瘤组与转移瘤组的长径、短径、平扫CT值及增强扫描三期CT值差异无统计学意义(P均>0.05)。腺瘤组的BF及BV值均高于转移瘤组((66.32±50.33) mL/(100 g·min)与(34.21±34.99) mL/(100 g·min),(18.81±5.93) mL/100 g与(8.06±5.44) mL/100 g,P=0.005、0.001);MTT、TP及PS值差异无统计学意义(P均>0.05)。BF及BV值鉴别腺瘤与转移瘤的ROC曲线下面积分别为0.875和0.923,灵敏度及特异度分别为92.3%和75.0%、84.6%和100%。结论:常规CT检查对鉴别肾上腺乏脂性腺瘤和肺癌肾上腺转移瘤存在一定困难,使用BF、BV值鉴别两者可获得较高的诊断效能。
Objective： To investigate the value of Revolution CT perfusion imaging in differentiating adrenal lipid-poor adenoma（adenoma in short） and adrenal metastases of lung cancer（metastases in short）. Materials and Methods： The data of adrenal Revolution CT perfusion scanning in our hospital were retrospectively collected, 13 cases of adenoma （CT value 〉10 HU） were pathologically confirmed, and 7 cases and 10 lesions of metastases were confirmed by clinical history and follow-up imaging. The size, unenhanced and enhanced CT attenuation numbers and perfusion parameter measurements （blood flow（BF）, blood volume（BY）, mean transit time（M3T）, time to peak（TP） and permeability of sufface（PS）） of tumors were recorded. Com- parison of the above parameters between adenomas and metastases was tested. Receiver operating characteristic （ROC） curves were plotted to analyze diagnostic efficiency. Results： There was not statistical difference of length, minimum width, unen- hanced CT value and enhanced CT values between adenoma and metastases group（all P〉0.05）. BF and BV values of adenoma were statistically higher than those of metastases（66.32±50.33 vs. （34.21±34.99）mL/（100 g.min）, 18.81：1：5.93 vs. （8.06＋5.44）mL/ 100 g, P=0.005 and 0.001, respectively）, while there was not statistical difference of MTF, TP and PS values between the two tumors （P all〉0.05）. The area under the ROC curve of BF and BV values were 0.875 and 0.923, and there were a sensitivity of 92.3% and 75.0%, and a specificity of 84.6% and 100% for differentiating adenoma from metastases. Conclusion： It is difficult to identify adrenal lipid-poor adenoma and adrenal metastases of lung cancer by routine CT examination. However, BF and BV values can be used to identify both of them for higher diagnostic efficacy.
作者
赵莹
刘爱连
刘静红
刘义军
王楠
方鑫
ZHA0 Ying, LIU Ai-lian, LIU Jing-hong, LIU Yi-jun, WANG Nan, FANG Xin(Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian Liaoning 116011, China)
出处
《中国临床医学影像杂志》
CAS
2018年第11期792-797,共6页
Journal of China Clinic Medical Imaging
关键词
肾上腺肿瘤
肺肿瘤
肿瘤转移
体层摄影术
X线计算机
Adrenal gland neoplasms
Lung neoplasms
Neoplasm metastasis
Tomography
X-ray computed
