Winklhofer Sebastian, Lin Wei-Ching, Lambert Jack W, Yeh Benjamin M
Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave., Box 0628, M-372, San Francisco, CA 94143-0628, USA; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave., Box 0628, M-372, San Francisco, CA 94143-0628, USA; Department of Radiology, China Medical University Hospital, No. 2, Yuh-Der Rd., Taichung 40447, Taiwan, Republic of China; Department of Biomedical Imaging and Radiological science, China Medical University, No. 91, Syueshih Rd., Taichung 40402, Taiwan, Republic of China.
Eur J Radiol. 2017 Feb;87:53-58. doi: 10.1016/j.ejrad.2016.12.003. Epub 2016 Dec 6.
To evaluate whether iodine quantification with Dual-Energy Computed Tomography (DECT) improves the differentiation of accessory spleens (AS) from lymph nodes (LN) compared to CT number measurements.
Abdominal DECT images of 75 patients with either AS (n=35) or LN (n=48) (benign entity) were retrospectively evaluated. Hounsfield Units (HU) and iodine concentrations of AS, LN and the main spleen were measured. Receiver operating characteristics (ROC) were performed to calculate an optimal threshold for distinguishing AS from LN. Sensitivity, specificity, and accuracy were calculated for distinguishing AS from LN by iodine concentration measurements.
Mean CT numbers and iodine concentrations were higher for AS (148±29 HU and 48.2±11×100μg/cc) than LN (83±19 HU and 31.5±6.2×100μg/cc, respectively, P<0.001 each). Mean CT numbers were lower for AS compared to the main spleen (161±29HU, P<0.01), whereas mean iodine concentrations (47.7±10×100μg/cc) were not significantly different (P=0.095). An iodine concentration greater than 38×100μg/cc suggested AS with a sensitivity, specificity and accuracy of 91%, 85%, and 88%, respectively (Area under ROC curve 0.941).
Iodine measurements might contribute to the differentiation of AS from LN. Iodine concentrations similar to that of the main spleen may help to confirm the diagnosis of AS.
评估与CT数值测量相比，双能计算机断层扫描（DECT）进行碘定量是否能改善副脾（AS）与淋巴结（LN）的鉴别诊断。
回顾性评估75例患有AS（n = 35）或LN（n = 48，良性病变）患者的腹部DECT图像。测量AS、LN和主脾的Hounsfield单位（HU）及碘浓度。采用受试者操作特征（ROC）曲线计算区分AS与LN的最佳阈值。通过碘浓度测量计算区分AS与LN的灵敏度、特异度和准确度。
AS的平均CT数值和碘浓度（分别为148±29 HU和48.2±11×100μg/cc）高于LN（分别为83±19 HU和31.5±6.2×100μg/cc，P均<0.001）。与主脾相比，AS的平均CT数值较低（161±29HU，P<0.01），而平均碘浓度（47.7±10×100μg/cc）无显著差异（P = 0.095）。碘浓度大于38×100μg/cc提示为AS，其灵敏度、特异度和准确度分别为91%、85%和88%（ROC曲线下面积为0.941）。
碘测量可能有助于AS与LN的鉴别诊断。与主脾相似的碘浓度可能有助于AS的确诊。
