双能量CT在评估鼻咽癌颅底骨侵犯中的价值研究

Evaluation of Dual⁃Energy CT for the Detection of Skull Base Invasion in Nasopharyngeal Carcinoma

目的:探讨双能量CT(DE⁃CT)在评价鼻咽癌颅底骨质侵犯中的价值,并与单能量CT(SE⁃CT)的诊断效能进行比较。方法:回顾性分析经病理证实的31例鼻咽癌患者及31名健康人的临床及影像资料。行配对样本t检验分析受侵犯骨质各参数的变化情况,绘制受试者操作曲线以比较SE⁃CT与DE⁃CT在评估鼻咽癌颅底骨质侵犯中的诊断效能。结果:与正常骨质相比,硬化骨质的标准碘浓度(nIC)值、有效原子序数(Zeff)值、K值、50 keV的虚拟单色图像(VMI)值以及120 kV的SE⁃CT值均显著增高(均P<0.05),破坏骨质的上述参数均显著降低(均P<0.05)。较SE⁃CT(骨质硬化AUC:0.802;骨质破坏AUC:0.804)而言,DE⁃CT多参数联合的ROC曲线下面积更高(骨质硬化AUC:0.889;骨质破坏AUC:0.976)。结论:DE⁃CT的nIC、Zeff、K值、50 keV的VMI值等参数可用于准确评估鼻咽癌患者的颅底骨质侵犯情况,且较SE⁃CT而言,DE⁃CT的多参数联合诊断效能更高。

Purpose:To explore the evaluation of dual-energy CT(DE-CT)for the detection skull base invasion in nasopharyngeal carcinoma(NPC),and compare the diagnostic performance of DE-CT with those of single-energy CT(SE-CT).Methods:The clinical and imaging data from 31 NPC patients and 31 healthy people were retrospectively assessed.The paired t test was used to show the differences of DECT parameters between invaded and normal bones,and the area under ROC curve was used to compare the diagnostic performance of DE-CT for detecting skull base invasion in NPC with those of SE-CT.Results:Compared with those in normal bones,normalized iodine concentration(nIC),effective atomic number(Zeff),K,50-90 keV virtual monochromatic images(VMI)and 120 kV SE-CT values were significantly higher in sclerotic bones and significantly lower in lytic bones(all P<0.05).Compared with SE-CT(AUC in sclerosis:0.802;AUC in lysis:0.804),DE-CT demonstrated better diagnostic performance for detecting skull base invasion in NPC(AUC in sclerosis:0.889;AUC in lysis:0.976).Conclusion:Parameters including nIC,Zeff,K values,50 keV VMI derived DE-CT could be used to precisely detect skull base invasion in NPC.Compared with SE-CT,DE-CT showed better diagnostic performance for detecting skull base invasion in NPC.