双能计算机断层扫描在口腔鳞状细胞癌颈部淋巴结转移术前诊断中的价值评价

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology Pub Date : 2025-01-22 DOI:10.1016/j.ajoms.2025.01.012

Erina Kitamoto , Toru Chikui , Kazutoshi Okamura , Kazuhito Hioki , Shintaro Kawano , Wataru Kumamaru , Tamotsu Kiyoshima , Osamu Togao , Kazunori Yoshiura

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引用次数: 0

摘要

目的探讨口腔鳞状细胞癌静脉期双能ct （DECT）鉴别转移淋巴结的有用参数。方法回顾性分析40例未见明显坏死的117个淋巴结（非转移性83个，转移性34个）。感兴趣的区域被定义为具有最大短直径的区域。计算与病理图像相关的9个参数：40、70、100 keV时虚拟单色x线图像CT值（HU40 keV、HU70 keV、HU100 keV）、碘浓度（IC）、40 - 70 keV （λ40-70 HU）、40 - 100 keV （λ40-100 HU）时CT值变化、淋巴结长径、短径、长短径比。结果转移性淋巴结的CT和IC值低于非转移性淋巴结。而短径的受者工作特征曲线下面积（AUC）最大，为0.846(95 %置信区间：0.741 ~ 0.914)，在截止值为7.54 mm时，灵敏度和特异度分别为82.4 %和84.3 %。对于CT值和IC的参数，HU100 keV的AUC最高（0.737），其次是HU70 keV（0.717）、HU40 keV（0.686）、IC（0.660）、λ40-100 HU（0.659）和λ40-70 HU（0.659）。6个dect衍生参数与短轴长度呈显著负相关。结论在静脉期，尽管dect衍生的参数存在显著差异，但最大短直径是鉴别转移淋巴结的最有用的参数。

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The evaluation of the usefulness of dual-energy computed tomography in the preoperative diagnosis of cervical lymph node metastases in oral squamous cell carcinoma

Objective

To evaluate useful parameters for differentiating metastatic lymph nodes in oral squamous cell carcinoma using dual-energy computed tomography (DECT) in the venous phase.

Methods

A total of 117 lymph nodes without visually obvious necrosis (83 non-metastatic and 34 metastatic) from 40 patients were retrospectively analyzed. The region of interest was defined at the area with the maximum short diameter. Nine parameters were calculated and correlated with the pathology images: CT values of virtual monochromatic X-ray images at 40, 70, and 100 keV (HU_40 keV, HU_70 keV, HU_100 keV), iodine concentration (IC), CT value variation at 40–70 keV (λ_40–70 _HU), 40–100 keV (λ_40–100 _HU), lymph node long diameter, short diameter, and long-short diameter ratio.

Results

Metastatic lymph nodes had lower CT and IC values than non-metastatic nodes. However, the short diameter had the highest the area under the receiver operating characteristic curve (AUC) with 0.846 (95 % confidence interval: 0.741–0.914), and the respective sensitivity and specificity were 82.4 % and 84.3 % at a cutoff of 7.54 mm. For parameters using CT values and IC, HU_100 keV had the highest AUC (0.737), followed by HU_70 keV (0.717), HU_40 keV (0.686), IC (0.660), λ_40–100 _HU (0.659), and λ_40–70 _HU (0.659). Six DECT-derived parameters showed the significant negative correlation to the short axis length.

Conclusion

In the venous phase, although the significant differences were found in the DECT-derived parameters, the maximal short diameter was found to be the most useful parameter for the differentiation of metastatic lymph nodes.

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