本文選題：腎上腺 + 腺瘤　； 參考：《天津醫(yī)科大學》2013年碩士論文

【摘要】：目的：探討CT直方圖分析的負值像素百分比對平掃CT值大于10HU的腎上腺乏脂腺瘤與非腺瘤的鑒別診斷價值。 材料和方法：回顧性分析經(jīng)手術病理證實或隨訪一年以上的192個腎上腺腫瘤,其中97個為平掃CT值小于10HU富脂性腺瘤,47個為平掃CT值大于10HU乏脂性腺瘤,48個為非腺瘤。測量每個富脂性腺瘤、乏脂性腺瘤與非腺瘤平掃CT值和經(jīng)CT直方圖分析測得的負值百分比并比較其間差異,對CT密度測量法與直方圖分析對于乏脂性腺瘤的敏感性和特異性進行對照分析。并利用受試者操作曲線(receiver operating characteristic curve, ROC曲線)選擇鑒別乏脂性腺瘤與非腺瘤的最合適閾值,同時評估乏脂性腺瘤的平掃CT值與負值像素百分比的關系。 結果：100%的富脂性腺瘤、約82%的乏脂性腺瘤及0.02%的非腺瘤的負值百分比大于10%。乏脂性腺瘤平掃CT值(24.90±9.58HU)與非腺瘤平掃CT值(35.48±8.37HU)無顯著差異(P0.05),乏脂性腺瘤的負值像素百分比(19.49±10.31%)高于非腺瘤(1.89±2.23%),二者具有顯著性差異(P=0.000)。31個平掃CT值位于10HU-30HU的乏脂性腺瘤負值像素百分比全部大于10%,而15個平掃CT值大于30HU的乏脂性腺瘤只有8個(53.33%)的負值百分比大于10%。當負值像素百分比取15%時,診斷乏脂性腺瘤的敏感性為61.7%,特異性為100%；負值像素百分比取10%時診斷乏脂性腺瘤的敏感性增加到80.9%,特異性為97.9%；而負值像素百分比取5%,診斷乏脂性腺瘤的敏感性增加95.7%,特異性降到93.7%。而平掃CT值小于10HU,得出診斷腺瘤的敏感性為67%,特異性為100%。 結論：CT直方圖分析可提高平掃CT對乏脂性腺瘤的診斷準確性,對平掃CT值為10-30HU之間的乏脂性腺瘤的診斷效能最高。
[Abstract]:Objective: To explore the value of CT histogram analysis in the differential diagnosis of adrenal fat and non adenoma with plain scan CT value greater than 10HU.
Materials and methods: retrospective analysis of 192 adrenal tumors confirmed by surgical pathology or more than one year, of which 97 were plain scan CT value less than 10HU rich adenoma, 47 for plain scan CT value greater than 10HU adenoma, 48 non adenoma. Measurement of every fat adenoma, non fat adenoma and non adenoma CT value and CT histogram The sensitivity and specificity of CT density measurement and histogram analysis were compared and the sensitivity and specificity of histogram analysis and histogram analysis were compared. And the most suitable threshold of non lipomatous adenomas and non adenomas was selected by using the receiver operating characteristic curve (ROC curve). The relationship between the plain CT value and the percentage of negative pixel was evaluated.
Results: 100% of the fat rich adenomas, about 82% of the adenoma and 0.02% of non adenoma, were higher than that of 10%. (24.90 + 9.58HU) and non adenoma (35.48 + 8.37HU). The negative pixel percentile ratio (19.49 + 10.31%) of the adenoma was higher than that of non adenoma (19.49 + 10.31%) (1.89 + 2.23%). Two There was a significant difference (P=0.000) the percentage of negative pixels in the 10HU-30HU adenoma at 10HU-30HU was more than 10% in 10HU-30HU, but only 8 (53.33%) of 15 plain scan CT values greater than 30HU were greater than 10%. when the percentage of negative pixels was 15%, the sensitivity of the diagnosed adenoma was 61.7%, and the specificity was 100%. The sensitivity of the negative pixel percentage 10% was increased to 80.9%, the specificity was 97.9%, the percentage of the negative pixel was 5%, the sensitivity of the diagnosed adenoma increased by 95.7%, the specificity dropped to 93.7%. and the CT value was less than 10HU, and the sensitivity of the diagnosis of adenoma was 67% and the specificity was 100%..
Conclusion: CT histogram analysis can improve the diagnostic accuracy of plain scan CT for the diagnosis of fat - wasting adenoma, and has the highest diagnostic efficiency for the patients with fat - wasting adenoma with a CT value of 10-30HU.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R816.7;R736.6

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