摘要
目的探讨双能量CT动脉期碘浓度及能谱曲线斜率诊断喉癌转移淋巴结的价值。方法收集具有完整术前双能量CT扫描资料并经病理证实的喉癌40例、淋巴结90枚,按病理结果将淋巴结分为转移组(47枚)和非转移组(43枚),比较转移组与非转移组淋巴结、原发灶与转移淋巴结动脉期碘浓度及能谱曲线斜率的差异,并绘制ROC曲线,计算曲线下面积(AUC)及最佳诊断阈值。结果转移淋巴结动脉期碘浓度及能谱曲线斜率分别为(2.29±0.50)mg/mL及(2.38±0.71)mg/mL,均高于非转移组(1.77±0.48)mg/mL及(1.99±0.63)mg/mL,差异均有统计学意义;动脉期碘浓度及能谱曲线斜率诊断淋巴结转移的阈值分别为1.85 mg/mL及2.15,对应AUC分别为0.77、0.67(均P<0.05)。喉癌原发灶与转移淋巴结动脉期碘浓度及能谱曲线斜率差异均无统计学意义(均P>0.05)。结论喉癌转移淋巴结与原发灶之间具有同源性,双能CT动脉期碘浓度及能谱曲线斜率对喉癌转移淋巴结的诊断有一定的价值。
Objective To investigate the value of arterial phase dual energy CT derived iodine concentration(IC)and energy spectrum slope(λHU)in the diagnosis of metastatic cervical lymph nodes of laryngeal carcinoma.Methods This study included 40 patients with laryngeal carcinoma who had complete pathological and dual energy CT data,and 90 lymph nodes were obtained and studied retrospectively(including 47 metastatic nodes and 43 non metastatic nodes).Independent sample t test was used to compare the differences of IC andλHU between meta static and non metastatic lymph nodes,and between primary laryngeal lesions and metastatic lymph nodes.The ROC curve is plotted,and the efficacy of the IC andλHU in detecting of metastatic cervical lymph was analyzed by calculating the area under the curve(AUC)and the optimal diagnostic threshold of the ROC curve.A p value less than 0.05 was considered as statistically significant.Results The IC andλHU of metastatic lymph nodes were(2.29±0.50)mg/mL and 2.38±0.71)mg/mL,which were both significantly higher than those in non metastatic lymph nodes(1.77±0.48)mg/mL and 1.99±0.63)mg/mL.The AUCs of IC andλHU in diagnosing metastatic lymph nodes were 0.77 and 0.67,respectively(P<0.05).Taking IC of 1.85mg/ml as cutoff value,the sensitivity and the specificity was 80.9%and 65.1%respectively,while the sensitivity and specificity for the diagnosis of met astatic lymph nodes in laryngeal carcinoma were 57.4%and 72.1%respectively withλHU=2.15 as the cutoff value.There were no difference in IC andλHU between the primary lesions and the metastatic cervical lymph nodes(P>0.05).Conclusions Arterial phase DECT derived IC andλHU have a promising future for the differentiate of cervi cal lymph nodes in laryngeal carcinoma.
作者
瞿姣
张梦梅
郑凌琳
赵卫
高洁
杨亚英
QU Jiao;ZHANG Mengmei;ZHENG Linglin;ZHAO Wei;GAO Jie;YANG Yaying(Department of Medical Imaging,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第20期3235-3238,共4页
The Journal of Practical Medicine
关键词
喉癌
淋巴结
体层摄影
X线计算机
双能量CT
碘浓度
laryngeal carcinoma
lymph node
tomography,x ray computer
dual energy CT
Iodine concentration
