基于碘图的光谱CT多模态参数成像在甲状腺乳头状癌中的诊断价值

Diagnostic value of multi-modality spectral CT imaging based on iodine maps in papillary thyroid carcinoma

目的 评估光谱CT定量增强成像在甲状腺乳头状癌(PTC)中的诊断价值。方法 回顾性分析2019年5月~2023年1月在中国人民解放军总医院海南医院行颈部光谱CT增强的59例患者能谱基数据,采用Multiphase软件生成动脉增强分数(AEF)图和细胞外容积(ECV)图,并测量病灶和正常甲状腺组织的AEF及ECV值。采用Mann-Whitney U检验进行组间比较,采用ROC曲线对AEF及ECV的诊断效能进行评估,并对比较曲线下面积的差异。结果 甲状腺乳头状癌病变的AEF及ECV值低于正常甲状腺组织的AEF及ECV值(UAEF=1311.00, PAEF=0.02;UECV=394.50, PECV<0.0001)。AEF、ECV及AEF联合ECV诊断PTC的曲线下面积分别为0.623、0.887及0.907,约登指数分别为0.271、0.661及0.678。AEF及ECV联合诊断PTC的模型为Y=-0.033×AEF-0.185×ECV+10.084(Y>0.697诊断PTC)。结论 光谱CT定量参数AEF联合ECV对PTC的诊断具有较高价值,可以作为诊断PTC的影像学标志物。

Objective To evaluate the diagnostic value of spectral CT with quantitative enhancement parameters in the papillary thyroid carcinoma(PTC).Methods Fifty cases with PTC were retrospectively studied by analyzing spectrum base image at the Hainan Hospital of PLA General Hospital from May 2019 to January 2023,which would generate arterial enhancement fraction(AEF)and extracellular volume fraction(ECV)images.The AEF and ECV value were measured in the lesion and normal thyroid tissue on the same level.Mann-Whitney U test was used for the group comparison,and ROC curve was used to evaluate the diagnostic efficacy of AEF and ECV with Z test for the area under the curve.Results The AEF and ECV value of PTC were significantly lower than that of normal thyroid tissue(UAEF=1311.00,PAEF=0.02;UECV=394.50,PECV<0.0001).The area under the curve of AEF,ECV and AEF combined with ECV were 0.623,0.887 and 0.907,and Youden index were 0.271,0.661and 0.678,respectively.The diagnostic model for the AEF combined with ECV was Y=-0.033×AEF-0.185×ECV+10.084(PTC was diagnosed when Y>0.697).Conclusion The spectrum CT quantitative parameters AEF combined with ECV could have a relative higher diagnostic value for PTC,which could be considered as imaging biomarker for the diagnosis of PTC.