双能量CT电子云密度/有效原子序数在成骨型转移瘤与骨岛中的鉴别诊断价值

徐驰杰; 孔玲玲; 邓小毅

doi:10.19732/j.cnki.2096-6210.2022.04.009

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双能量CT电子云密度/有效原子序数在成骨型转移瘤与骨岛中的鉴别诊断价值

论著 | 更新时间：2025-12-15

- 双能量CT电子云密度/有效原子序数在成骨型转移瘤与骨岛中的鉴别诊断价值
- The utility of electron density/effective atomic number value in dual energy computed tomography for differentiation of osteoblastic metastases and bone islands
- 肿瘤影像学 2022年31卷第4期页码：403-408
- 作者机构：
- 作者简介：
- 基金信息：
  
  江苏大学临床医学科技发展基金（JLY20180151）;张家港市科技支撑计划（社会发展）项目（ZKS1933）
- DOI：10.19732/j.cnki.2096-6210.2022.04.009
  中图分类号：
- 网络出版：2022-08-28，
  
  纸质出版：2022-08-28
- 稿件说明：
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徐驰杰,孔玲玲,邓小毅. 双能量CT电子云密度/有效原子序数在成骨型转移瘤与骨岛中的鉴别诊断价值[J]. 肿瘤影像学, 2022, 31(4): 403-408 https://doi.

org/10.19732/j.cnki.2096-6210.2022.04.009
徐驰杰,孔玲玲,邓小毅. 双能量CT电子云密度/有效原子序数在成骨型转移瘤与骨岛中的鉴别诊断价值[J]. 肿瘤影像学, 2022, 31(4): 403-408 https://doi. DOI： 10.19732/j.cnki.2096-6210.2022.04.009.

org/10.19732/j.cnki.2096-6210.2022.04.009 DOI：

摘要

目的：

旨在探讨双能量计算机体层成像（computed tomography，CT）电子云密度（electron density，Rho）/有效原子序数（effective atomic number，Z）在成骨型转移瘤与骨岛中的鉴别诊断价值。

方法：

前瞻性纳入2020年3月2021年6月江苏大学附属澳洋医院104例经病理学检查确诊的恶性肿瘤患者，行双能量CT检查。结合临床及影像随访最终确诊34例成骨型转移瘤患者224个病灶，70例骨岛患者108个病灶。测量所有病灶的Z、Rho、双能量指数（dual energy index，DEI）及常规CT（regular CT value，rCT）定量值。各参数采用独立样本t检验分析进行比较。使用受试者工作特征（receiver operating characteristic，ROC）曲线比较各参数对成骨型转移瘤与骨岛的鉴别诊断效能。

结果：

成骨型转移瘤和骨岛在双能量CT图像上Z、Rho、DEI、rCT值分别为11.20.7、（359.9132.1）HU、0.0620.012、（607.6211.5）HU和12.20.4、（582.3118.0）HU、0.0820.009、（1036.9189.1）HU。成骨型转移瘤平均值均明显低于骨岛而标准差（standard deviation，SD）高于骨岛（

＜0.001）。ROC曲线显示，rCT=770.8 HU时曲线下面积为0.886，灵敏度、特异度为76.3%和82.4%；当Z、Rho、DEI阈值分别为11.9、556.1 HU和0.907时，曲线下面积分别为0.917、0.889和0.907，灵敏度分别为90.2%、94.2%和87.9%，特异度分别为84.3%、68.5%和84.3%。

结论：

相较于常规CT，双能量CT Rho/Z能提供多参数定量分析，对骨岛与成骨型转移瘤两者的鉴别诊断效能更优。

Abstract

Objective:

To study the differential diagnosis value of dual energy computed tomography (CT) electron density (Rho)/ef

fective atomic number (Z) in osteoblastic metastases and bone islands.

Methods:

A total of 104 patients with malignant tumors diagnosed by pathological biopsy in Jiangsu University Affiliated AoYang Hospital from March 2020 to June 2021 were prospectively included and underwent dual-energy CT examination. All the lesions were comprehensively diagnosed based on clinical and imaging follow-up results. Among them

34 patients were diagnosed with 224 bone metastatic tumors

and 70 patients were diagnosed with 108 bone islands. The Z

Rho

dual energy index (DEI) and regular CT value (rCT) values of all lesions were measured. The differences between the parameters were compared by t test analysis. Receiver operating characteristic (ROC) curve analysis was used to compare the differential diagnostic performance of parameters for osteoblastic metastases and bone islands.

Results:

The Z

Rho

DEI

and rCT values of osteoblastic metastases and bone islands on dual-energy CT images were 11.20.7

(359.9132.1) HU

0.0620.012

(607.6211.5) HU

and 12.20.4

(582.3118.0) HU

0.0820.009

(1036.9189.1) HU. The average value of osteoblastic metastases was significantly lower than that of bone islands and the standard deviation (SD) value was higher than that of bone islands (

＜0.001). The ROC curves showed that when the rCT value was 770.8 HU

AUC=0.886

and the corresponding sensitivity and specificity were 76.3% and 82.4%. When the thresholds of Z

Rho and DEI were 11.9

556.1 HU and 0.907

the area under curve were 0.917

0.889 and 0.907

and the corresponding sensitivities were 90.2%

94.2% and 87.9%

and specificities were 84.3%

68.5% and 84.3%

respectively.

Conclusion:

Compared with conventional CT

the utility of Rho/Z derivedof Dual-energy CT can provide Z

Rho and DEI multi-parameter quantitative values for analysis

and has better differential diagnosis performance for osteoblastic metastases and bone islands.

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