背景:目前,颌骨肿瘤的分化主要基于病变的形态而不是强化特征,这对整个身体肿瘤的分化很重要。关于颌骨肿瘤的增强特征的文献很少。这主要是因为,即使使用计算机断层扫描(CT)来评估这些病变,它们通常在没有静脉造影的情况下成像。这项研究假设,颌骨肿瘤的实体成分的增强特征除了通过双能CT进行形态学外,还可以帮助区分这些病变,因此提高了区分各种病理的能力。
目的:评估CT中对比增强和双能定量参数在颌骨肿瘤分化中的作用。
方法:57例颌骨肿瘤患者行对比增强双能量CT检查。肿瘤的形态学分析,包括增强固体成分,完成了,其次是碘浓度的定量分析(IC),水浓度(WC),HU,和归一化IC。根据组织病理学分析将研究人群分为四个亚组-中央型巨细胞肉芽肿(CGCG),成釉细胞瘤,牙源性角化囊肿(OKC),和其他颌骨肿瘤。使用参数变量的单向ANOVA检验和非参数变量的Kruskal-Wallis检验。如果发现显著差异,使用一系列独立的t检验或Mann-WhitneyU检验。
结果:成釉细胞瘤是最常见的病理(n=20),其次是CGCG(n=11)和OKC。CGCG显示所有定量参数的平均浓度均高于成釉细胞瘤(P<0.05)。31.35×100μg/cm3的IC阈值具有最大的灵敏度(81.8%)和特异性(65%)。在成釉细胞瘤和OKC之间,前者显示所有定量参数的平均浓度较高(P<0.001),然而,当比较单眼成釉细胞瘤与OKC时,后者显示出明显较高的WC。此外,与“其他颌骨肿瘤”组相比,成釉细胞瘤的IC较高,WC较低。
结论:固体成分的增强特性结合双能量参数为区分颌骨肿瘤提供了更精确的方法。
BACKGROUND: Currently, the differentiation of jaw tumors is mainly based on the lesion\'s morphology rather than the enhancement characteristics, which are important in the differentiation of neoplasms across the body. There is a paucity of literature on the enhancement characteristics of jaw tumors. This is mainly because, even though computed tomography (CT) is used to evaluate these lesions, they are often imaged without intravenous contrast. This study hypothesised that the enhancement characteristics of the solid component of jaw tumors can aid in the differentiation of these lesions in addition to their morphology by dual-energy CT, therefore improving the ability to differentiate between various pathologies.
OBJECTIVE: To evaluate the role of contrast enhancement and dual-energy quantitative parameters in CT in the differentiation of jaw tumors.
METHODS: Fifty-seven patients with jaw tumors underwent contrast-enhanced dual-energy CT. Morphological analysis of the tumor, including the enhancing solid component, was done, followed by quantitative analysis of iodine concentration (IC), water concentration (WC), HU, and normalized IC. The study population was divided into four subgroups based on histopathological analysis-central giant cell granuloma (CGCG), ameloblastoma, odontogenic keratocyst (OKC), and other jaw tumors. A one-way ANOVA test for parametric variables and the Kruskal-Wallis test for non-parametric variables were used. If significant differences were found, a series of independent t-tests or Mann-Whitney U tests were used.
RESULTS: Ameloblastoma was the most common pathology (n = 20), followed by CGCG (n = 11) and OKC. CGCG showed a higher mean concentration of all quantitative parameters than ameloblastomas (P < 0.05). An IC threshold of 31.35 × 100 μg/cm3 had the maximum sensitivity (81.8%) and specificity (65%). Between ameloblastomas and OKC, the former showed a higher mean concentration of all quantitative parameters (P < 0.001), however when comparing unilocular ameloblastomas with OKCs, the latter showed significantly higher WC. Also, ameloblastoma had a higher IC and lower WC compared to \"other jaw tumors\" group.
CONCLUSIONS: Enhancement characteristics of solid components combined with dual-energy parameters offer a more precise way to differentiate between jaw tumors.