能谱CT定量参数对于鉴别胸腺良恶性肿瘤病变的价值研究

Study on the Value of Quantitative Parameters of Energy Spectrum CT in Differentiating Benign and Malignant Thymic Tumors

目的探讨能谱CT定量参数对于鉴别胸腺良恶性肿瘤病变的价值。方法收集2017年4月-2022年5月我院经手术病理证实的胸腺肿瘤86例,将其分为三组,分别为低危组(A型、AB型、B1型)31例、高危组(B2型、B3型)27例和胸腺癌组(C型)28例。所有患者均行能谱CT扫描,在后处理工作站处理图像并测量相关数据,从而计算出标准化碘浓度(NIC)、能谱曲线斜率(k)及70keV单能量水平对应的△CT值。采取受试者工作特征(ROC)曲线分析能谱CT定量参数鉴别胸腺肿瘤良恶性的诊断效能。结果低危组、高危组和胸腺癌组在动脉期、静脉期70keVCT值比较差异均无统计学意义(P>0.05)。动脉期低危组胸腺肿瘤NIC和k均高于高危组、胸腺癌组(P<0.05),动脉期高危组胸腺肿瘤NIC和k与胸腺癌组比较差异无统计学意义(P>0.05)。静脉期低危组胸腺肿瘤NIC和k均高于高危组、胸腺癌组,且高危组高于胸腺癌组(P<0.05)。动脉期的NIC和k、静脉期的NIC和k指标单独应用时,曲线下面积(AUC)分别为0.788、0.728、0.723、0.715,4个指标联合应用时,AUC为0.877,其中联合应用诊断效能更高。结论能谱CT定量参数可在一定程度上鉴别胸腺肿瘤的良恶性,且联合应用诊断效能较高。

Objective To explore the value of quantitative parameters of energy spectrum CT in differentiating benign and malignant thymic tumors.Methods From April 2017 to May 2022,86 cases of thymic tumors confirmed by surgery and pathology in our hospital were collected and divided into three groups.There were 31 cases in low-risk group(type A,AB and B1),27 cases in high-risk group(type B2 and B3)and 28 cases in thymic cancer group(type C).All patients were scanned with energy spectrum CT and the images were processed at the post-processing workstation and the relevant data were measured.The normalized iodine concentration(NIC),the slope of the energy spectrum curve(k)and the△CT value corresponding to the single energy level of 70keV were calculated.The ROC curve was used to analyze the diagnostic efficacy of quantitative parameters of energy spectrum CT in differentiating benign and malignant thymic tumors.Results There was no significant difference in 70keV CT value between low-risk group,high-risk group and thymic cancer group in arterial phase and venous phase(P>0.05).NIC and k of low-risk group were higher than those of high-risk group and thymic cancer group(P<0.05).There was no significant difference in NIC and k between highrisk group of arterial stage and thymic cancer group(P>0.05).NIC and k of thymic tumors in low-risk group in venous phase were higher than those in high-risk group and thymic cancer group,and those in high-risk group were higher than those in thymic cancer group(P<0.05).The area under the curve(AUC)was 0.788,0.728,0.723 and 0.715 when NIC and k in arterial phase and venous phase were applied alone.The AUC was 0.877 when the four indicators were applied together,and the diagnostic efficiency was higher when combined.Conclusion The quantitative parameters of energy spectrum CT can distinguish the benign and malignant thymic tumors to a certain extent,and the combined application has high diagnostic efficiency.