PDF(Pubmed)
Abstract：
BACKGROUND: Skull base invasion in nasopharyngeal carcinoma (NPC) was shown to be a poor negative prognostic factor, and dual-energy CT (DECT) has heralded a new approach to detect this condition. The study aims to evaluate the value of DECT for detection of skull base invasion in NPC and compare the diagnostic performance of DECT with those of simulated single-energy CT (SECT) and MRI.
METHODS: The imaging findings of 50 NPC patients and 31 participants in control group which underwent DECT examinations were assessed in this retrospective study. The skull base invasions were evaluated using 5-point scale by two blind observers. ROC analysis, Mcnemar test, paired t test, weighted K statistics and intraclass correlation coefficient were performed to evaluate the diagnostic performance of simulated SECT, MRI and DECT.
RESULTS: Quantitative analysis of DECT parameters showed higher normalized iodine concentration and effective atomic number values in sclerosis and lower values in erosion than those in normal bones (both p < 0.05). Compared with simulated SECT and MRI, the diagnostic sensitivity for DECT was significantly improved from 75% (simulated SECT) and 84.26% (MRI) to 90.74% (DECT) (both p < 0.001), specificity from 93.23% and 93.75% to 95.31 (both p < 0.001), accuracy from 86.67% and 90.33% to 93.67%, and AUC from 0.927 and 0.955 to 0.972 (both p < 0.05), respectively.
CONCLUSIONS: DECT demonstrates better diagnostic performance than simulated SECT and MRI for detecting skull base invasions in NPC, even those slight bone invasions in early stage, with higher sensitivity, specificity and accuracy.
METHODS: The imaging findings of 50 NPC patients and 31 participants in control group which underwent DECT examinations were assessed in this retrospective study. The skull base invasions were evaluated using 5-point scale by two blind observers. ROC analysis, Mcnemar test, paired t test, weighted K statistics and intraclass correlation coefficient were performed to evaluate the diagnostic performance of simulated SECT, MRI and DECT.
RESULTS: Quantitative analysis of DECT parameters showed higher normalized iodine concentration and effective atomic number values in sclerosis and lower values in erosion than those in normal bones (both p < 0.05). Compared with simulated SECT and MRI, the diagnostic sensitivity for DECT was significantly improved from 75% (simulated SECT) and 84.26% (MRI) to 90.74% (DECT) (both p < 0.001), specificity from 93.23% and 93.75% to 95.31 (both p < 0.001), accuracy from 86.67% and 90.33% to 93.67%, and AUC from 0.927 and 0.955 to 0.972 (both p < 0.05), respectively.
CONCLUSIONS: DECT demonstrates better diagnostic performance than simulated SECT and MRI for detecting skull base invasions in NPC, even those slight bone invasions in early stage, with higher sensitivity, specificity and accuracy.
摘要：
背景：鼻咽癌（NPC）的颅底浸润被证明是不良的负面预后因素，双能CT（DECT）预示着一种新的方法来检测这种情况。本研究旨在评估DECT检测NPC颅底侵犯的价值，并比较DECT与模拟单能量CT（SECT）和MRI的诊断性能。
方法：在这项回顾性研究中，评估了50例接受DECT检查的NPC患者和31例对照组参与者的影像学表现。由两名盲人观察者使用5点量表评估颅底侵入。ROC分析,Mcnemar测试,配对t检验，加权K统计量和组内相关系数来评估模拟SECT的诊断性能，MRI和DECT。
结果：DECT参数的定量分析显示，与正常骨骼相比，硬化中的标准化碘浓度和有效原子序数值较高，而侵蚀值较低（均p<0.05）。与模拟SECT和MRI相比，DECT的诊断灵敏度从75%(模拟SECT)和84.26%(MRI)显著提高到90.74%(DECT)(均p<0.001),特异性从93.23%和93.75%到95.31(均p<0.001)，准确度从86.67%和90.33%到93.67%，和AUC从0.927和0.955到0.972（均p<0.05），分别。
结论：DECT在检测NPC颅底侵犯方面比模拟SECT和MRI表现出更好的诊断性能，即使是那些早期的轻微骨侵入，具有更高的灵敏度，特异性和准确性。
方法：在这项回顾性研究中，评估了50例接受DECT检查的NPC患者和31例对照组参与者的影像学表现。由两名盲人观察者使用5点量表评估颅底侵入。ROC分析,Mcnemar测试,配对t检验，加权K统计量和组内相关系数来评估模拟SECT的诊断性能，MRI和DECT。
结果：DECT参数的定量分析显示，与正常骨骼相比，硬化中的标准化碘浓度和有效原子序数值较高，而侵蚀值较低（均p<0.05）。与模拟SECT和MRI相比，DECT的诊断灵敏度从75%(模拟SECT)和84.26%(MRI)显著提高到90.74%(DECT)(均p<0.001),特异性从93.23%和93.75%到95.31(均p<0.001)，准确度从86.67%和90.33%到93.67%，和AUC从0.927和0.955到0.972（均p<0.05），分别。
结论：DECT在检测NPC颅底侵犯方面比模拟SECT和MRI表现出更好的诊断性能，即使是那些早期的轻微骨侵入，具有更高的灵敏度，特异性和准确性。
