MSCT双期增强扫描对腮腺Warthin瘤的诊断价值

The Value of Dual-phase Multi-slice Enhanced CT in Diagnosis of Parotid Warthin Tumor

目的评价双期增强MSCT扫描对腮腺warthjn瘤的诊断价值，并明确鉴别Warthin瘤与非Warthin瘤的关键参数。方法回顾性分析腮腺肿物患者的术前影像资料．所有患者均在术前行双期增强CT扫描。所有患者经手术治疗，并取得病理结果。将肿瘤分为两组，Warthin瘤与非Warthin瘤。计算和分析CT增强幅度、相对廓清率、绝对廓清率。并比较两组间诊断的敏感性、特异性、阳性预测值与阴性预测值。结果腮腺双期增强CT扫描中，Warthin瘤和非Warthin瘤的病灶增强幅度、相对廓清率及绝对廓清率具有显著性差异，经独立T检验P值均〈0．05。运用Roc曲线分别确定其判断参数（闽值），当增强幅度大于445Hu、相对廓清率大于10.5％、绝对廓清率大于22.5％时，诊断Warthin瘤的敏感性及特异性均较高。腮腺双期增强CT扫描中，以相对廓清率大于10．5％、绝对廓清率大于22．5％，及CT增强幅度为44．5HU作为评判标准，能更准确的诊断Warthin瘤。结论CT双期扫描检查，廓清率是诊断Warthin瘤的一项有价值的参数。

Objective To determine the value of dual-phase enhancing CT scan in diagnosing Warthin tumor, and to find key parameters that are used to difference Warthin tumor from non-Warthin tumor. Methods CT Images of patients known or suspected to have parotid tumor were retrospectively analyzed. All the images were obtained with dual-phase MSCT study before surgeries. The tumors were divided into two groups： Warthin tumor and non-Warthin tumor. The enhancing intensity, relative wash-out rate and absolute wash-out rate were analyzed, and the sensitivity, specificity, positive predictive value and negative predictive value were compared between the two groups respectively. Results There are significant difference among the enhancing intensity, relative wash-out rate and absolute wash-ant rate with independent T test between Warthin tumor and non-Warthin tumor in the dual-phase MSCT and all the p-value is less than 0.05. Warthin tumor is more likely to be diagnosed with high sensitivity and specificity with the standard of relative wash-out rate was larger than 10.5%, absolute wash-out rate larger than 22.5% and a increased CT value more than 44.5HU determined by the ROC curves. Conclusion In dual-phase MSCT scanning, Wash-ant rate is a valuable examination parameter in diagnosing Warthin tumor.