摘要
目的比较宝石能谱CT血管成像与DSA对原发性肝癌供血动脉的判定价值。方法选取我院拟行经导管化疗栓塞术的患者49例,术前均行能谱CT肝脏动脉血管成像和DSA检查。4位独立的审阅医师按照5分评分法分别对能谱CTA和DSA影像对原发性肝癌供血动脉的把握程度进行评分,并采用受试者特性曲线(ROC)分析两者的区别。以手术医师综合分析能谱CTA、DSA影像及术后1周平扫CT影像后的诊断为标准,记录两种不同检查方法对原发性肝癌供血动脉显示的敏感度、特异度、准确度和阳性预测值。结果 49例患者中共选取了83例可疑为肿瘤供血动脉的血管,其中52例被证实为肿瘤供血动脉,31例被证实为非肿瘤供血动脉。能谱CTA的ROC曲线下面积(AZ=0.9954)明显高于DSA(AZ=0.8492),差异具有统计学意义(P<0.05)。能谱CTA的肝癌供血动脉判定的敏感度为96.63%,特异度为96.77%,精确度为96.69%,阳性预测值为98.05%,明显高于DSA(75%,73.39%,74.40%,82.54%)(P<0.05)。结论能谱CT血管成像对原发性肝癌供血动脉的显示优于DSA。
Objective This study compares the diagnostic value of Dual-energy computed tomography angiography （DECTA） with digital subtraction angiography （DSA） before transeatheter chemoemboliazation of hepatocellular carcino ma. Methods Fourty nine consecutive patients with hepatocellular carcinoma （HCC） underwent DECTA and DSA before superselective TACE. Angiographic operators determined which feeding arteries were potentially supplying the target tumor. Four independent observers separately viewed the DSA and DECTA images and a 5-point grading scale was ased to determine whether a studied artery supplied the target tumor. Diagnostic performance was compared using receiver operat- ing characteristic （ROC） analysis. Sensitivity, specificity, accuracy and positive predictive value （PPV） were calculated for arteries rated as definite or probable tumor feeding arteries. The judgment of angiographic and iodized oil accumulation on follow-up CT were the reference standard. Results We chose 83 possible feeding arteries in 49 patients. Among the studied arteries, 52 were verified tumor feeding arteries, and remaining 31 were not. DECTA resulted in a significantly larger area under the ROC curve （AZ=0. 9954） compared with DSA （AZ=0. 8492）. The sensitivity, specificity, accuracy and PPV of DECTA （96.63%, 96.77~/oo, 96.69o/00 and 98.05% respectively） were significantly higher than those for DSA （75~, 73.39%, 74.40% and 82.54%）. Conelusion Dual-energy CT angiography is more valuable than DSA to display tumor-feeding vessels before TACE for HCC.
出处
《医学影像学杂志》
2013年第11期1718-1723,共6页
Journal of Medical Imaging
关键词
双能量CT
肿瘤供血动脉
原发性肝癌
血管成像
Dual-energy CT
Tumor feeding vessels
Hepatocellular carcinoma
Angiography
