通过静脉注射对比增强CT结肠成像评估息肉和肿块的组织病理学

Assessment of polyp and mass histopathology by intravenous contrast-enhanced CT colonography.

作者信息

Summers Ronald M, Huang Adam, Yao Jianhua, Campbell Shannon R, Dempsey Jennifer E, Dwyer Andrew J, Franaszek Marek, Brickman Danny S, Bitter Ingmar, Petrick Nicholas, Hara Amy K

机构信息

Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bldg. 10, Room 1C351, 10 Center Dr. MSC 1182, Bethesda, MD 20892-1182, USA.

出版信息

Acad Radiol. 2006 Dec;13(12):1490-5. doi: 10.1016/j.acra.2006.09.051.

DOI:10.1016/j.acra.2006.09.051

PMID:17138117

Abstract

RATIONALE AND OBJECTIVES

We sought to demonstrate that intravenous contrast-enhanced CT colonography (CTC) can distinguish colonic adenomas from carcinomas.

METHODS

Supine intravenous contrast-enhanced CTC with colonoscopic and/or surgical correlation was performed on 25 patients with colonic adenomas or carcinomas. Standard deviation of mean polyp CT attenuation was computed and assessed using ANOVA and receiver-operating characteristic analyses.

RESULTS

Colonoscopy confirmed 32 polyps or masses 1 to 8 cm in size. The standard deviations of CT attenuation were carcinomas (n = 13; 36 +/- 6 HU; range 28-48 HU) and adenomas (n = 19; 49 +/- 14 HU; range 31-100 HU) (P = 0.005). At a standard deviation threshold of 42 HU, the sensitivity and specificity for classifying a polyp or mass as a carcinoma were 92% and 79%, respectively. The area under the receiver-operating characteristic curve was 0.89 +/- 0.06 (95% confidence interval 0.73-0.96).

CONCLUSIONS

Measurement of the standard deviation of CT attenuation on intravenous contrast-enhanced CTC permits histopathologic classification of polyps 1 cm or larger as carcinomas versus adenomas. The presence of ulceration or absence of muscular invasion in carcinomas creates overlap with adenomas, reducing the specificity of carcinoma classification.

摘要

原理与目的

我们试图证明静脉注射对比剂增强的CT结肠成像（CTC）能够区分结肠腺瘤与癌。

方法

对25例患有结肠腺瘤或癌的患者进行仰卧位静脉注射对比剂增强的CTC检查，并与结肠镜检查和/或手术结果进行对照。计算息肉平均CT衰减的标准差，并使用方差分析和受试者操作特征分析进行评估。

结果

结肠镜检查证实有32个大小为1至8厘米的息肉或肿块。CT衰减的标准差在癌（n = 13；36±6 HU；范围28 - 48 HU）和腺瘤（n = 19；49±14 HU；范围31 - 100 HU）之间（P = 0.005）。在标准差阈值为42 HU时，将息肉或肿块分类为癌的敏感性和特异性分别为92%和79%。受试者操作特征曲线下面积为0.89±0.06（95%置信区间0.73 - 0.96）。