Department of Radiology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul 143-729, Korea.
Korean J Radiol. 2014 Jan-Feb;15(1):72-9. doi: 10.3348/kjr.2014.15.1.72. Epub 2014 Jan 8.
To compare the diagnostic performance and radiation dose between contrast-enhanced CT (ECT) alone, and combined unenhanced and contrast-enhanced CT (UE + ECT) for the assessment of adnexal mass.
This retrospective study was approved by the Institutional Review Board. A total of 146 consecutive patients (mean age, 41.1 years) who underwent preoperative unenhanced and contrast-enhanced multidetector CT of the pelvis and had adnexal masses found at surgery were included. Two readers independently evaluated the likelihood of adnexal malignancy on a 5-point scale on two different imaging datasets (ECT alone and UE + ECT). The area under the receiver operating characteristic curve (AUC) was used to evaluate diagnostic performance. Radiation dose to patients was calculated by the volume CT dose index (CTDIvol) and the dose length products (DLP) on each dataset.
Of the total 178 adnexal masses, 133 masses were benign and 45 masses were malignant. For both readers, there is no significant difference of AUC values between ECT alone and UE + ECT for the detection of adnexal malignancy (reader 1, 0.93 vs. 0.95; reader 2, 0.92 vs. 0.91) (p > 0.05). The mean CTDIvol (12.6 ± 2.2 mGy) and DLP (641.2 ± 137.2 mGy) of ECT alone was significantly lower than the mean CTDIvol (21.5 ± 2.7 mGy) and DLP (923.6 ± 158.8 mGy) of UE + ECT (p < 0.0001).
The use of unenhanced CT scan in addition to contrast-enhanced CT scan does not improve the detection of adnexal malignancy, but increases radiation exposure.
比较单独对比增强 CT（ECT）与联合平扫和增强 CT（UE + ECT）在评估附件肿块中的诊断性能和辐射剂量。
本回顾性研究经机构审查委员会批准。共纳入 146 例连续患者（平均年龄 41.1 岁），这些患者均在术前接受盆腔多排螺旋 CT 平扫和增强检查，且术中发现附件肿块。两名读者分别在两个不同的影像数据集（ECT 单独和 UE + ECT）上，独立地使用 5 分制评估附件恶性肿瘤的可能性。受试者工作特征曲线（ROC）下面积（AUC）用于评估诊断性能。使用每个数据集的容积 CT 剂量指数（CTDIvol）和剂量长度乘积（DLP）来计算患者的辐射剂量。
在总共 178 个附件肿块中，133 个为良性肿块，45 个为恶性肿块。对于两位读者，ECT 单独和 UE + ECT 检测附件恶性肿瘤的 AUC 值均无显著差异（读者 1，0.93 比 0.95；读者 2，0.92 比 0.91）（p＞0.05）。ECT 单独的平均 CTDIvol（12.6±2.2 mGy）和 DLP（641.2±137.2 mGy）明显低于 UE + ECT 的平均 CTDIvol（21.5±2.7 mGy）和 DLP（923.6±158.8 mGy）（p＜0.0001）。
在增强 CT 扫描的基础上增加平扫并不能提高附件恶性肿瘤的检出率，但会增加辐射暴露。
