国际医学放射学杂志
國際醫學放射學雜誌
국제의학방사학잡지
International Journal of Medical Radiology
2015年
5期
413-417
,共5页
李妍卓%蔡权宇%贾宁阳%陈栋%龙行安%邵丹丹%俞莺%程红岩
李妍卓%蔡權宇%賈寧暘%陳棟%龍行安%邵丹丹%俞鶯%程紅巖
리연탁%채권우%가저양%진동%룡행안%소단단%유앵%정홍암
能谱成像%碘基图%肝内胆管细胞癌%非典型肝细胞癌
能譜成像%碘基圖%肝內膽管細胞癌%非典型肝細胞癌
능보성상%전기도%간내담관세포암%비전형간세포암
Spectral imaging%Iodine-based material decomposition image%Intrahepatic cholangiocarcinoma%Atypical hepatocellular carcinoma
目的：探讨能谱CT 碘基图对鉴别肝内胆管细胞癌（ICC）与非典型肝细胞癌（AHCC）的临床价值。方法回顾性分析我院2013年4月—2014年2月间经病理证实为肝癌的52例病人（ICC 24例，AHCC 28例）的动脉期、门静脉期及平衡期能谱影像。测量ICC及AHCC 2组病灶和正常肝实质的3期碘浓度值，计算平衡期与动脉期病灶碘浓度差值（EAD）及平衡期病灶与正常肝实质碘浓度差值（LNDE），并对测量和计算结果分别进行两组间独立样本t检验及ROC曲线分析。结果 ICC的3期碘浓度值明显高于AHCC的，两组间差异均有统计学意义（均P<0.01）；ICC的EAD值及LNDE值明显高于AHCC的，两组间差异均有统计学意义（均P<0.01）。ROC曲线分析示平衡期碘浓度值、EAD 和 LNDE 鉴别 ICC 和 AHCC 的敏感度和特异度分别为95.8%、92.9%，62.5%、89.2%，95.8%、82.1%。结论能谱CT碘定量测定能够定量评价ICC的强化特点，平衡期的碘定量分析在ICC与AHCC的鉴别诊断方面具有较高的价值。
目的：探討能譜CT 碘基圖對鑒彆肝內膽管細胞癌（ICC）與非典型肝細胞癌（AHCC）的臨床價值。方法迴顧性分析我院2013年4月—2014年2月間經病理證實為肝癌的52例病人（ICC 24例，AHCC 28例）的動脈期、門靜脈期及平衡期能譜影像。測量ICC及AHCC 2組病竈和正常肝實質的3期碘濃度值，計算平衡期與動脈期病竈碘濃度差值（EAD）及平衡期病竈與正常肝實質碘濃度差值（LNDE），併對測量和計算結果分彆進行兩組間獨立樣本t檢驗及ROC麯線分析。結果 ICC的3期碘濃度值明顯高于AHCC的，兩組間差異均有統計學意義（均P<0.01）；ICC的EAD值及LNDE值明顯高于AHCC的，兩組間差異均有統計學意義（均P<0.01）。ROC麯線分析示平衡期碘濃度值、EAD 和 LNDE 鑒彆 ICC 和 AHCC 的敏感度和特異度分彆為95.8%、92.9%，62.5%、89.2%，95.8%、82.1%。結論能譜CT碘定量測定能夠定量評價ICC的彊化特點，平衡期的碘定量分析在ICC與AHCC的鑒彆診斷方麵具有較高的價值。
목적：탐토능보CT 전기도대감별간내담관세포암（ICC）여비전형간세포암（AHCC）적림상개치。방법회고성분석아원2013년4월—2014년2월간경병리증실위간암적52례병인（ICC 24례，AHCC 28례）적동맥기、문정맥기급평형기능보영상。측량ICC급AHCC 2조병조화정상간실질적3기전농도치，계산평형기여동맥기병조전농도차치（EAD）급평형기병조여정상간실질전농도차치（LNDE），병대측량화계산결과분별진행량조간독립양본t검험급ROC곡선분석。결과 ICC적3기전농도치명현고우AHCC적，량조간차이균유통계학의의（균P<0.01）；ICC적EAD치급LNDE치명현고우AHCC적，량조간차이균유통계학의의（균P<0.01）。ROC곡선분석시평형기전농도치、EAD 화 LNDE 감별 ICC 화 AHCC 적민감도화특이도분별위95.8%、92.9%，62.5%、89.2%，95.8%、82.1%。결론능보CT전정량측정능구정량평개ICC적강화특점，평형기적전정량분석재ICC여AHCC적감별진단방면구유교고적개치。
Objective To explore the clinical value of spectral CT Iodine-based material decomposition imaging in differentiating intrahepatic cholangiocarcinoma ( ICC ) from atypical hepatocellular carcinoma ( AHCC ) . Methods Retrospectively analyzed 52 patients of our hospital during April 2013-February 2014 who underwent tri-phase enhanced spectral CT imaging including arterial phase, portal venous phase and equilibrium phase. Primary hepatocellular carcinoma (ICC patients 24 cases, AHCC patients 28 cases)was pathologically confirmed in each case. The Iodine concentrations of ICC, AHCC, and normal hepatic tissue in tri-phase were measured. The iodine concentration differences between equilibrium phase and arterial phase (EAD), lesion and normal hepatic tissue iodine concentration difference during equilibrium phase (LNDE) were calculated. The group differences of ICC and AHCC were evaluated by two samples t test and receiver operating characteristic curve (ROC) analysis. Results During arterial phase, portal venous phase, and equilibrium phase, the mean iodine concentrations of ICC were significantly higher than those of AHCC (P<0.01). The EAD and LNDE of ICC were significantly higher than those of AHCC (P<0.01). ROC analysis showed that the sensitivity and specificity of the iodine concentration during equilibrium phase, EAD and LNDE in differentiating between ICC and AHCC were 95.8%and 92.9%, 62.5%and 89.2%, 95.8%and 82.1%, respectively. Conclusion Spectral CT iodine-based material decomposition image is a suitable tool to quantitatively evaluate contrast enhancement characteristics of ICC, the iodine concentration measurement during equilibrium phase performs best in differentiating AHCC from ICC.
