双能CT碘图在小喉癌术前诊断中的应用

Application of iodine images with dual-energy CT in diagnosis of small laryngeal carcinomas

目的探讨双能CT碘图在小喉癌术前诊断中的应用价值。方法选择经手术病理证实的小喉癌患者69例,其中男性65例,女性4例;年龄37~87岁,中位年龄60岁。分析其常规增强和双能CT图像,根据常规增强CT图、碘图表现对肿瘤进行诊断,并将CT碘图术前T分期结果与手术病理诊断结果对照。结果小喉癌在双能CT碘图上表现为病灶部位碘浓聚和/或软组织肿块形成,其诊断假阴性率(1.96%)低于常规增强CT(5.88%);碘图对小喉癌术前T分期的准确率分别是T1期97.4%(38/39),T2期90.0%(27/30),总准确率为94.2%(65/69),术前分期与病理分级的一致性具有统计学意义(Kappa值=0.881,P <0.05)。结论双能CT碘图能准确地显示小喉癌的部位、形态及侵犯范围,其术前T分期与病理分级一致性好,具有重要的诊断价值。

Objective To assess the value of iodine images with dual-energy CT in diagnosis of small laryngeal carcinomas.Methods A total of 69 small laryngeal carcinoma patients confirmed with pathology diagnoses were enrolled, which included65 males and 4 females, aged 37-87 years old with median age of 60 years old. The images of conventional enhancement and dual-energy CT were analyzed. The tumor was diagnosed according to conventional enhanced CT image and iodine image,the preoperative T staging result of CT iodine images and surgical pathological results were compared. Results Small laryngeal cancers showed enhancement on iodine images of dual-energy CT, the diagnostic false negative rate(1.96 %) was lower than that of conventional enhanced CT(5.88 %);The accuracy of preoperative T staging was 97.4 %(38/39) in T1 and 90.0 %(27/30) in T2, the total accuracy was 94.2 %(65/69). The consistency between preoperative staging and pathological grading was statistically significant(P < 0.05). Conclusion It is demonstrated that dual-energy CT iodine image could accurately display the location, morphology and extent of small laryngeal carcinomas, the preoperative T staging and pathological grading are consistent with important diagnostic value.