CT“切缘征”鉴别直径<4 cm复杂胸腺囊肿与胸腺上皮肿瘤

CT"cut-edge sign"for differentiating complex thymic cyst and thymic epithelial tumor with diameter less than 4 cm

目的观察CT“切缘征”鉴别直径<4 cm复杂胸腺囊肿与胸腺上皮肿瘤(TET)的价值。方法回顾性分析24例接受胸部CT平扫及双期增强扫描、并经手术病理证实的复杂胸腺囊肿(囊肿组)及14例TET(TET组)患者;由2名医师分别评估CT图像“切缘征”,以组内相关系数(ICC)评价观察者间评估结果的一致性;采用logistic回归分析比较2组CT“切缘征”检出率;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),分析CT“切缘征”鉴别复杂胸腺囊肿与TET的效能。结果观察者间评估“切缘征”结果的一致性良好[ICC=0.94,95%CI(0.90,0.97)]。囊肿组CT“切缘征”检出率为62.50%(15/24),高于TET组的14.29%(2/14,P<0.01)。以CT“切缘征”鉴别复杂胸腺囊肿与TET的敏感度、特异度、准确率及AUC分别为62.50%(15/24)、85.71%(12/14)、71.05%(27/38)及0.74。结论CT“切缘征”有助于鉴别直径<4 cm复杂胸腺囊肿与TET。

Objective To observe the value of CT"cut-edge sign"for differentiating complex thymic cyst and thymic epithelial tumor(TET)with diameter less than 4 cm.Methods Data of 24 patients with complex thymic cyst(complex thymic cyst group)and 14 patients with TET(TET group)confirmed by surgical pathology who underwent plain and dual-phase enhanced chest CT scanning were retrospectively analyzed.CT"cut-edge sign"was evaluated by 2 physicians,and the inter-observer consistency was evaluated using intra-class correlation coefficient(ICC).The detection rate of CT"cut-edge sign"was compared between groups using logistic regression analysis.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of CT"cut-edge sign"for differentiating complex thymic cyst and TET.Results The inter-observer consistency of CT"cut-edge sign"was good(ICC=0.94,95%CI[0.90,0.97]).The detection rate of CT"cut-edge sign"in complex thymic cyst group was 62.50%(15/24),higher than in TET group(2/14,14.29%)(P<0.01).The sensitivity,specificity,accuracy and AUC of CT"cut-edge sign"for differentiating complex thymic cyst and TET was 62.50%(15/24),85.71%(12/14),71.05%(27/38)and 0.74,respectively.Conclusion CT"cut-edge sign"was helpful for differentiating complex thymic cyst and TET with diameter less than 4 cm.