中国中西医结合影像学杂志2025，Vol.23Issue(2)：145-149,154,6.DOI:10.3969/j.issn.1672-0512.2025.02.003
双层探测器光谱CT多参数成像术前预测粗梁实体型肝细胞癌的价值
Predictive value of dual-layer spectral detector CT multi-parameter imaging for macrotrabecular-massive hepatocellular carcinoma(MTM-HCC)
摘要
Abstract
Objective:To investigate the predictive value of dual-layer spectral detector CT(DLCT)multi-parameter imaging for macrotrabecular-massive hepatocellular carcinoma(MTM-HCC).Methods:This retrospective study included 52 HCC patients,classified into MTM-HCC group(18 cases)and non-MTM-HCC group(34 cases)based on postoperative histopathology.Qualitative imaging features were evaluated on 40 keV virtual monoenergetic images(VMI),including tumor size,non-peripheral arterial hyperenhancement,non-peripheral portal phase washout,irregular tumor margins,capsule integrity,intratumoral necrosis,intratumoral vessels,and arterial phase intratumoral hypovascular components.Quantitative parameters were measured during portal and equilibrium phases,including iodine concentration(IC),normalized iodine concentration(NIC),effective atomic number(Zeff),and spectral curve slope(λ).Independent t-tests and χ2 tests compared quantitative and qualitative data,respectively.Multivariate logistic regression identified independent predictors of MTM-HCC,followed by ROC curve analysis to evaluate diagnostic performance.Results:Significant intergroup differences were observed in AFP,arterial phase intratumoral hypovascular components,and IC,Zeff,and λ during portal and equilibrium phases(all P<0.05).Multivariate logistic regression analysis identified arterial phase intratumoral hypovascular components and equilibrium phase IC as independent predictors of MTM-HCC(OR=5.494,21.071,both P<0.05).The AUCs for predicting MTM-HCC were 0.714(arterial phase intratumoral hypovascular components),0.761(equilibrium phase IC),and 0.829(the combined model).Conclusions:The arterial phase intratumoral hypovascular components and equilibrium phase IC derived from DLCT have significant potential for predicting MTM-HCC,and their combined model has a better diagnostic efficiency for MTM-HCC.关键词
癌,肝细胞/粗梁实体型/光谱成像/体层摄影术,X线计算机Key words
Carcinoma,hepatocellular/Macrotrabecular-massive subtype/Spectral imaging/Tomography,X-ray computed引用本文复制引用
于永泉,梁逍雪,侯国旗,陈杏彪,侯红军,张洪胜..双层探测器光谱CT多参数成像术前预测粗梁实体型肝细胞癌的价值[J].中国中西医结合影像学杂志,2025,23(2):145-149,154,6.基金项目
山东省医药卫生科技发展计划项目(202209010213). （202209010213）
