影像科学与光化学 ›› 2022, Vol. 40 ›› Issue (6): 1339-1342.DOI: 10.7517/issn.1674-0475.220720

• 综述与论文 • 上一篇    下一篇

能谱CT用于肝细胞肝癌诊断的灵敏性及准确性分析

王学玲, 袁青玲, 杨娟   

  1. 青海省人民医院影像中心, 青海 西宁 810000
  • 收稿日期:2022-07-15 出版日期:2022-11-23 发布日期:2022-11-15
  • 通讯作者: 王学玲

Sensitivity and Accuracy Analysis of Energy Spectrum CT for the Diagnosis of Hepatocellular Carcinoma

WANG Xueling, YUAN Qingling, YANG Juan   

  1. Imaging Center of Qinghai Provincial People's Hospital, Xining 810000, Qinghai, P. R. China
  • Received:2022-07-15 Online:2022-11-23 Published:2022-11-15

摘要: 本研究探讨能谱CT在肝细胞肝癌诊断中的价值。选取110例肝占位性病变患者,均给予能谱CT、螺旋CT检查。110例患者中,确诊肝细胞肝癌患者88例,局灶性结节增生患者22例。能谱CT诊断肝细胞肝癌的灵敏性、准确率和阴性预测值高于螺旋CT(P<0.05);在肿瘤直径<3cm中,能谱CT检出率高于螺旋CT(P<0.05)。肝细胞肝癌患者动脉期病灶碘摄取比值(IUR)、门静脉期IUR、动脉期标准化碘浓度(NIC)、动脉期病灶能谱曲线斜率(S)和门静脉期S明显低于局灶性结节增生患者(P<0.05)。动脉期IUR、门静脉期IUR、动脉期NIC、动脉期S和门静脉期S诊断肝细胞肝癌的ROC曲线的曲线下面积(AUC)分别为0.846、0.767、0.753、0.811和0.715(P<0.05),上述参数联合诊断的AUC为0.921,灵敏性和特异性分别为90.00%和88.00%。能谱CT在肝细胞肝癌诊断中有较好的应用价值,值得临床使用。

关键词: 能谱CT, 螺旋CT, 肝细胞肝癌, 诊断价值

Abstract: This study investigated the value of spectral CT in the diagnosis of hepatocellular carcinoma. 110 cases of liver space occupying lesions were selected, all of them were given spectral CT and spiral CT examination. Among the 110 patients, 88 were diagnosed as hepatocellular carcinoma and 22 as focal nodular hyperplasia. The sensitivity, accuracy and negative predictive value of spectral CT in the diagnosis of hepatocellular carcinoma were significantly higher than those of spiral CT (P<0.05). In tumor diameter <3 cm, the detection rate of spectral CT was higher than that of spiral CT (P<0.05). The ratio of iodine uptake (IUR) in arterial phase, IUR in portal vein phase, standardized iodine concentration (NIC) in arterial phase, slope of energy spectrum curve (S) in arterial phase and S in portal vein phase of hepatocellular carcinoma were significantly lower than those in focal nodular hyperplasia (P<0.05). The area under the ROC curve (AUC) of arterial IUR, portal IUR, arterial NIC, arterial S and portal S in the diagnosis of hepatocellular carcinoma were 0.846, 0.767, 0.753, 0.811 and 0.715, respectively (P<0.05), the AUC of the combined diagnosis of the above parameters was 0.921, and the sensitivity and specificity were 90.00% and 88.00%, respectively. Energy spectrum CT has good application value in the diagnosis of hepatocellular carcinoma and is worthy of clinical use.

Key words: energy spectrum CT, spiral CT, hepatocellular carcinoma, diagnostic value