腮腺原发良恶性肿瘤的鉴别:基于双层探测器能谱CT定量参数联合形态学特征OA
Differentiation of primary benign and malignant tumors of the parotid gland:based on quantitative parameters of dual-layer detector spectral CT combined with morphological features
目的 探讨双层探测器能谱CT定量参数联合形态学特征在鉴别腮腺原发良恶性肿瘤中的诊断价值.方法 回顾性收集广西壮族自治区南溪山医院2021年6月～2025年6月经病理证实的腮腺原发肿瘤82例,所有患者术前2周内均行双层探测器能谱CT增强检查,依据病理分为良性组(n=64)和恶性组(n=18).分析患者的临床资料,记录良恶性肿瘤的形态学特征(包括肿瘤数量、部位、肿瘤最大径、边缘、囊变、黏液变、钙化)、能谱CT定量参数(包括动脉期及静脉期的碘浓度、标准化碘浓度、有效原子序数、虚拟平扫CT值、能谱曲线斜率、40、70、100、140 keV单能量CT值).采用二元多因素logistic回归分析筛选出独立预测因子.采用ROC曲线评估各独立预测因子的诊断效能及其联合诊断效能.结果 在形态学特征方面,肿瘤最大径、边缘、部位在良性组与恶性组之间的差异有统计学意义(P=0.041、0.004、0.043),边缘为独立预测因子(P<0.05);在能谱CT定量参数方面,动脉期70、100、140 keV的CT值、静脉期碘浓度(ICv)在两组间的差异有统计学意义(P=0.030、0.003、0.004、0.029),ICv为独立预测因子(P<0.05).ROC曲线分析显示,肿瘤边缘和ICv联合构建的模型(AUC=0.822)优于肿瘤边缘模型(AUC=0.685)、ICv模型(AUC=0.741).结论 相较于能谱CT定量参数或形态学特征,两者联合对鉴别腮腺原发良恶性肿瘤的诊断效能更高.
Objective To investigate the diagnostic value of quantitative parameters of dual-layer detector spectral CT combined with morphological features in differentiating primary benign and malignant tumors of the parotid gland.Methods A retrospective study was conducted in 82 cases with parotid gland primary tumors confirmed by pathology from June 2021 to June 2025 at Nanxishan Hospital of Guangxi Zhuang Autonomous Region.All patients underwent dual-layer detector spectral CT contrast-enhanced examination within 2 weeks before the operation.The cases were classified into benign group(n=64)and malignant group(n=18)according to pathology.The clinical data of the patients were recorded.The morphological features(including tumor amount,location,maximum diameter,margin,cystic change,mucinous change,and calcification)and quantitative parameters of spectral CT(including iodine concentration,normalized iodine concentration,effective atomic number,virtual non-contrast CT value,spectral curve slope,and monoenergetic CT values at 40,70,100,140 keV level during arterial and venous phases)of benign and malignant tumors were recorded.Differences between the two groups were compared.Binary multivariate logistic regression analysis was used to screen out independent predictors.The diagnostic efficacy of each independent predictor and their combined diagnostic efficacy were evaluated with ROC curve.Results In terms of morphological features,significant differences were found in maximum diameter,margin,and location between benign group and malignant group(P=0.041,0.004,0.043),and margin was an independent predictor(P<0.05);In terms of quantitative parameters of spectral CT,significant differences were found in CT values at arterial phase 70,100,140 keV,and iodine concentration during venous phase(ICv)between the two groups(P=0.030,0.003,0.004,0.029),and ICv was an independent predictor(P<0.05).ROC curve analysis showed that the model(AUC=0.822)constructed by combining tumor margin and ICv was superior to the tumor margin model(AUC=0.685)and the ICv model(AUC=0.741).Conclusion Compared with quantitative parameters of spectral CT or morphological features,the combination of them has better diagnostic efficacy in differentiating primary benign and malignant tumors of the parotid gland.
刘福珍;眭玉祥;唐玲;罗婉莹;蒋雯慧;周志强;周颖珠;李鑫;覃小燕
广西壮族自治区南溪山医院医学影像科,广西 桂林 541002中南大学湘雅二医院桂林医院急诊科,广西 桂林 541001广西壮族自治区南溪山医院医学影像科,广西 桂林 541002广西壮族自治区南溪山医院医学影像科,广西 桂林 541002广西壮族自治区南溪山医院医学影像科,广西 桂林 541002广西壮族自治区南溪山医院医学影像科,广西 桂林 541002广西壮族自治区南溪山医院医学影像科,广西 桂林 541002广西壮族自治区南溪山医院医学影像科,广西 桂林 541002广西壮族自治区南溪山医院医学影像科,广西 桂林 541002
腮腺良性肿瘤腮腺恶性肿瘤能谱CT定量参数形态学特征
benign tumor of parotid glandmalignant tumor of parotid glandspectral CTquantitative parametersmorphological features
《分子影像学杂志》 2026 (2)
169-176,8
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20201422)
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