能谱CT容积定量参数术前预测肝细胞癌微血管侵犯

Spectrum CT volumetric quantitative parameters for preoperatively predicting microvascular invasion of hepatocellular carcinoma

目的 观察能谱CT容积定量参数术前预测肝细胞癌(HCC)微血管侵犯(MVI)的价值。方法 回顾性分析50例经手术病理确诊HCC患者的临床及术前腹部能谱CT资料,包括22例MVI(+)和28例MVI(-),以单因素分析及多因素logistic回归分析筛选HCC MVI的临床、实验室检查指标、病灶CT表现及增强动脉期、门脉期能谱CT常规和容积定量参数相关独立预测因素,构建回归模型。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估独立预测因素及回归模型对MVI的预测效能。结果 中性粒细胞与淋巴细胞比值(NLR)及能谱CT容积分析增强动脉期病灶碘浓度(IC)是HCC MVI的独立预测因素(OR=2.929、1.589,P=0.008、P<0.001),其预测HCC MVI的AUC分别为0.761和0.846,回归模型的AUC为0.898。结论 术前可根据能谱CT容积定量参数有效预测HCC MVI。

Objective To investigate the value of spectrum CT volumetric quantitative parameters for preoperatively predicting microvascular invasion(MVI)of hepatocellular carcinoma(HCC).Methods Clinical and preoperative abdominal spectrum CT data of 50 patients with HCC confirmed by surgical pathology were retrospectively analyzed,including 22 cases of MVI(+)and 28 of MVI(-).Univariate analysis and multivariate logistic regression were used to screen the independent predictors of HCC MVI among clinical and laboratory data,focal CT features,conventional and volumetric quantitative parameters of spectrum CT in arterial phase and portal venous phase,and then a regression model was constructed.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the predictive efficacy of independent predictors and regression model for MVI.Results Neutrophil-lymphocyte ratio(NLR)and enhanced arterial phase iodine concentration(IC)of lesions in spectrum CT volumetric analysis were independent predictors for HCC MVI(OR=2.929,1.589,P=0.008,P<0.001),with AUC for predicting HCC MVI of 0.761 and 0.846,respectively,while the AUC of regression model was 0.898.Conclusion Spectrum CT volumetric quantitative parameters could effectively predict MVI of HCC before operation.