ssDECT增强扫描碘浓度鉴别良恶性浆膜腔积液

Iodine-density analysis of enhanced ssDECT imaging tor differentiation of benign and malignant serous cavity effusion

目的探讨单源双能量CT增强扫描三期碘浓度对良恶性浆膜腔积液的鉴别诊断价值。方法回顾性分析我院行单源双能量CT增强扫描、并经穿刺脱落细胞学检査证实的浆膜腔积液患者65例,其中良性积液23例,恶性积液42例。采用单源双能量CT综合分析平台,在常规混合能量扫描下分别测量计算平扫及动脉期、静脉期、延迟期的标准化CT值(NCTval;NCTval_N、NCTval_A、NCTval_P、NCTval_D);并计算三期标准化CT值强化程度(NCT;NCT_A、NCT_P、NCT_D)。采用能谱分析软件于碘(水)图像上分别测量并计算平扫及增强三期标准化碘浓度(NIC;NIC_N、NIC_A、NIC_p、NIC_D);计算增强三期碘浓度强化程度(IC;IC_A、IC_P、IC_D)。比较良恶性浆膜腔积液的NCTval、NCT、NIC、1C,并进行ROC曲线分析计算各参数诊断良恶性浆膜腔积液的敏感度和特异度。结果增强三期良、恶性浆膜腔积液NCTval、NCT差异均无统计学意义(P均>0.05),而NIC、IC差异均有统计学意义(P均<0.05)。增强三期中IC_D的曲线下面积最大(0.82),当阈值为0.04时,敏感度、特异度分别为76.2%,69.6%。结论单源双能量CT增强扫描碘浓度可为鉴别良恶性浆膜腔积液提供一种敏感、有效的方法。

Objective To assess the value of iodine concentration of single source dual energy CT（ssDECT） enhanced scanning in differentiating malignant and benign serous cavity effusion.Methods Totally 65 patients with histopathological or laboratory proven serous cavity effusion underwent ssDECT imaging,including 23 cases of benign serous cavity effusion and 42 cases of malignant serous cavity effusion.The mean CT value（NCTval） of quality check images at plain scanning and enhancement scanning were measured（NCTvalN,NCTvalA,NCTvalP,NCTvalD）,and the enhanced degree of CT values（NCT） between plain scanning and enhancement scanning（NCTA,NCTP,NCTD） were calculated,respectively.Using the spectral analysis software,the normalized iodine concentration（NIC） of plain scanning and enhancement scanning were measured,and the enhanced degree of NIC（IC） were also calculated,respectively（ICA,ICP,ICD）.The difference of these parameters was evaluated statistically.The NCTval,NCT,NIC,IC were statistically analyzed between malignant and benign serous cavity effusion,and the sensitivity,specificity,area under curve（AUC） and threshold of the ROC curve were carried out.Results The NCTval and NCT between malignant and benign serous cavity effusion had no statistically significant difference（both P〉0.05）.The NIC and IC showed statistically significant difference between malignant and benign serous cavity effusion at the three phases（both P〈0.05）.ICD had the highest AUC（0.82）,the sensitivity,specificity was 76.2%and 69.6%when the threshold was 0.04.Conclusion The iodine concentration with the ssDECT enhanced scanning provides a new,sensitive and effective approach for identifying benign and malignant serous cavity effusion.