Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, PR China.
Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, PR China.
Eur J Radiol. 2020 Mar;124:108824. doi: 10.1016/j.ejrad.2020.108824. Epub 2020 Jan 9.
To explore the value of dual-energy CT for the differentiation between stage T1 nasopharyngeal carcinoma (NPC) and lymphoid hyperplasia (LH).
Patients with histopathological proven nasopharyngeal lesions (stage T1 NPCs, n = 30; LHs, n = 47) who underwent dual-energy CT were enrolled in this retrospective study. Quantitative parameters derived from dual-energy CT were measured. Statistical analyses were performed using the independent sample t-test, Wilcoxon rank sum test, and receiver operating characteristic curve (ROC) analysis.
There was significantly higher iodine concentration (IC), normalized iodine concentration (NIC, to internal jugular vein) in NPC compared with LH (p < 0.001). The effective atomic number (Z) was significantly higher in NPC than that in LH (p < 0.001). The virtual monochromatic images (VMIs) at 50 keV-110 keV (20 keV-interval) of NPC were all significantly higher than those of LH (all p <0.001). The slope (k) value of spectral attenuation curve was also significantly higher in NPC than LH (p < 0.001). There was no significant difference in virtual noncontrast (VNC) and 130 keV-190 keV (20 keV-interval) between the NPC and LH. For discriminating NPC from LH, the area under curve (AUC) using 70 keV was the highest in all single parameter (AUC, 0.92; sensitivity, 80.00 %; specificity, 91.49 %). Combined multiple parameters (IC, NIC, Z, 50 keV, 70 keV, 90 keV, slope (k)) by performing multivariate logistic regression model significantly improve the diagnostic capability in differentiating these two entities, with AUC, sensitivity, and specificity values of 0.99, 93.33 %, 97.87 %, respectively.
Dual-energy CT can be helpful for the differentiation between NPC and LH lesions.
探讨双能 CT 对 T1 期鼻咽癌（NPC）与淋巴组织增生（LH）鉴别诊断的价值。
回顾性分析经病理证实的鼻咽部病变患者（T1 期 NPC 患者 30 例，LH 患者 47 例）的双能 CT 资料。测量双能 CT 定量参数。采用独立样本 t 检验、Wilcoxon 秩和检验和受试者工作特征曲线（ROC）分析进行统计学分析。
NPC 的碘浓度（IC）、内颈静脉标准化碘浓度（NIC）明显高于 LH（均 P < 0.001）。NPC 的有效原子序数（Z）明显高于 LH（均 P < 0.001）。NPC 的虚拟单能量图像（VMIs）在 50 keV-110 keV（20 keV 间隔）均明显高于 LH（均 P < 0.001）。NPC 的光谱衰减曲线斜率（k）值也明显高于 LH（均 P < 0.001）。NPC 的虚拟平扫（VNC）和 130 keV-190 keV（20 keV 间隔）与 LH 之间无显著差异。在鉴别 NPC 与 LH 方面，70 keV 时单参数曲线下面积（AUC）最高（AUC 为 0.92，敏感度为 80.00%，特异度为 91.49%）。采用多元逻辑回归模型对 IC、NIC、Z、50 keV、70 keV、90 keV、斜率（k）等多参数进行联合分析，可显著提高鉴别这两种病变的诊断效能，AUC、敏感度、特异度分别为 0.99、93.33%、97.87%。
双能 CT 有助于鉴别 NPC 与 LH 病变。
