双能CT定量参数对甲状腺乳头状癌颈侧区淋巴结转移的预测价值.

Objective To explore the value of quantitative dual-energy CT(DECT)parameters for predicting lateral cervical lymph node metastasis(LLNM)in patients with papillary thyroid carcinoma(PTC). Methods DECT of 216 patients with pathologically confirmed PTC including 174 with LLNM and 42 without LLNM was retrospectively analyzed. Quantitative DECT parameters including iodine concentration(IC), effective atomic number(Zeff), slope of spectral Hounsfield unit curve(λHU), normalized IC(NIC)and normalized Zeff(NZeff)in the non-contrast, arterial and venous phases were compared. Binary logistic regression was applied to analyze the independent predictors. Receiver operating characteristic(ROC)curve analysis was used to evaluate the performance of independent predictors and their combinations for predicting the LLNM. Results Compared with the non-LLNM group, LLNM group showed significantly lower NIC(Z=-2. 279, P=0. 023)in the non-contrast phase, higher IC, NIC, NZeff and λHU in the arterial phase(all P＜0. 05), and higher IC, NIC, Zeff and λHU in the venous phase(all P＜0. 05). Binary logistic regression analysis showed that NICs in the non-contrast and venous phases were independent predictors of LLNM. The predictive performance of the combined non-contrast and venous phase model is optimal with an area under ROC curves(AUC)of 0. 672(95％CI:0. 605-0. 734), sensitivity of 63. 79％, specificity of 66. 67％, followed by NIC in the venous phase(AUC=0. 634)and NIC in the non-contrast phase(AUC=0. 613). Conclusion DECT derived quantitative parameters can assist in predicting LLNM in patients with PTC. [ABSTRACT FROM AUTHOR]