胰腺浆液寡囊性腺瘤和黏液性囊性腺瘤的 CT 能谱成像鉴别诊断：初步结果。

Differential diagnosis of pancreatic serous oligocystic adenoma and mucinous cystic neoplasm with spectral CT imaging: initial results.

机构信息

Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 2nd Ruijin Road, Shanghai 200025, China.

出版信息

Clin Radiol. 2014 Oct;69(10):1004-10. doi: 10.1016/j.crad.2014.05.003. Epub 2014 Jun 8.

DOI:10.1016/j.crad.2014.05.003

PMID:24919983

Abstract

AIM

To investigate the imaging characteristics of pancreatic serous oligocystic adenoma (SOA) and mucinous cystic neoplasms (MCNs) using spectral computed tomography (CT) and to evaluate whether quantitative information derived from spectral imaging can improve the differential diagnosis of these diseases.

MATERIALS AND METHODS

From February 2010 to June 2013, 44 patients (24 SOAs and 20 MCNs) who underwent spectral CT imaging were included in the study. Conventional characteristics and quantitative parameters were compared between the two disease groups. Logistic regression was used for multiparametric analysis. The receiver-operating characteristic curve was used to evaluate the diagnostic performance of single parameter and multiparametric analysis. Two radiologists diagnosed the diseases blinded and independently, without and with the information of the statistical analysis.

RESULTS

Tumour location, contour, size, and monochromatic CT values at 40 keV to 70 keV, iodine concentration, and effective atomic number (effective-Z) in the late arterial phase were the independent factors correlated with category. Multiparametric analysis with logistic regression showed that tumour size, location, and contour were the most effective variations, and obtained an area under the ROC curve (AUC) of 0.934. With the knowledge of statistical analysis, the accuracy of the first reader increased from 70.5% to 86.4%, and the accuracy of the second reader increased from 81.8% to 90.9%.

CONCLUSIONS

Although CT spectral imaging provided additional information and multiparametric analysis obtained better performance than single-parameter analysis in differentiating MCNs from SOAs, multiparametric analysis with the combination of quantitative parameters derived from CT spectral imaging did not improve the diagnostic performance. Tumour size, location, and contour played an important role in differentiating MCNs from SOAs.

摘要

目的

利用能谱 CT 研究胰腺浆液寡囊性腺瘤（SOA）和黏液性囊腺瘤（MCN）的成像特征，并评价从能谱成像获得的定量信息是否能提高对这两种疾病的鉴别诊断能力。

材料与方法

2010 年 2 月至 2013 年 6 月，44 例患者（24 例 SOA 和 20 例 MCN）接受了能谱 CT 成像检查，对两组疾病的常规特征和定量参数进行了比较。采用多元逻辑回归进行多参数分析。采用受试者工作特征曲线评估单参数和多参数分析的诊断性能。两名放射科医生分别独立进行诊断，诊断时不知道也没有进行统计分析的信息。

结果

肿瘤位置、轮廓、大小、40keV 至 70keV 单能量 CT 值、碘浓度和有效原子序数（effective-Z）在晚期动脉期是与分类相关的独立因素。多元逻辑回归多参数分析显示，肿瘤大小、位置和轮廓是最有效的变化，ROC 曲线下面积（AUC）为 0.934。在知道统计分析结果的情况下，第一位读者的准确性从 70.5%提高到 86.4%，第二位读者的准确性从 81.8%提高到 90.9%。