Va lue fo single-source dual-energyC T (ssDECT) in differen tiatingl ipid-po or adr enal aden omas from metsa tatci l esions
10.3760/cma.j.issn.0253-3766.2016.11.005
- VernacularTitle:单源双能量 CT 平扫对肾上腺乏脂性腺瘤与转移瘤的鉴别价值
- Author:
Ye JU
1
;
Ailian LIU
;
Heqing WANG
;
Yijun LIU
;
Jinghong LIU
;
Anliang CHEN
;
Lihua CHEN
;
Ye LI
;
Zheng HAN
Author Information
1. 116011,大连医科大学附属第一医院放射科
- Keywords:
Adrenal neoplasms;
Diagnosis;
Adrenal metastases;
Tomography,X-ray computer;
Dual-energy CT
- From:
Chinese Journal of Oncology
2016;38(11):826-832
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of single-source dual-energy CT ( ssDECT ) in differentiating lipid-poor adenomas from metastases in adrenal glands .Methods From August 2011 to Oct 2014,63 patients with 73 adrenal nodules ( 53 metastases proven by 5-6 months follow-up, and 20 histopathologically proven adenomas , CT value >10 HU) underwent ssDECT scanning .The CT values of conventional polychromatic CT and virtual monochromatic images ( 40-140 keV) , fat-water density images and effective atomic number (eff-Z) were reconstructed on an ADW4.5 workstation and ROC curves were then constructed to evaluate the effectiveness of each parameter .The slope of spectral curve was measured and divided into 3 types:increment curve ( K>0.1) , straight curve (-0.1≤K≤0.1) and decrement curve ( K<-0.1) according to the slope ( the value of K ) of spectral curve , and the curve patterns in the two groups were compared statistically .Results There was no statistical difference between the mean CT values of metastases (35.12±5.29)HU and lipid-poor adenomas (32.48±6.94)HU by conventional polychromatic CT (P>0.05).The range of single-energy CT values of metastases [from (53.00±15.12) HU to (33.38± 5.67) HU] was significantly higher than that of lipid-poor adenomas [from (26.90±26.94) HU to (28.77± 10.66) HU] at energy levels ranging from 40 to 80 keV ( P<0.05).There was no significant difference between the single-energy CT value of metastases and lipid-poor adenomas at energy levels ranging from 90 to 140 keV (P>0.05).The median fat-water concentration of metastases was -164.61 μg/cm3, significantly lower than that of lipid-poor adenomas (114.32 μg/cm3, P<0.05).The eff-Z of metastases (7.76±0.15) was also significantly higher than that of lipid-poor adenomas (7.50±0.25, P<0.05).When the threshold of fat-water concentration was -143.89 μg/cm3 , the sensitivity, specificity and accuracy rate of metastasis diagnosis was 70.0%, 66.0%, and 76.7%, respectively.When the threshold of eff-Z was 7.63, the sensitivity , specificity and accuracy rate of metastasis diagnosis was 83.0%, 65.0%, and 80.4%, respectively .The lower the energy , the higher the diagnostic accuracy at energy levels ranging from 40 to 80 keV, and that of 40 keV was the highest .The spectral curves of metastases included 2 ( 3.8%) ascending curves, 9 (17.0%) straight curves and 42 (792.%) descending curves, while in the 20 lipid-poor adenomas, there were 9 ( 45.0%) ascending curves , 4 ( 20.0%) straight curves and 7 ( 35.0%) descending curves , showing significant differences between the two groups ( P<0.05) .Conclu sions Single-source dual-energy CT provides an effective multi-parameter approach for differentiating lipid-poor adrenal adenomas from metastases .
