Differential diagnosis of mass-like polyps and tumors in nasal cavity and paranasal sinus with quantitative parameters of dual-energy CT iodine map / 中国医学影像技术

ABSTRACT

Objective: To explore the value of quantitative parameters of dual-energy CT arterial iodine map for differentiating nasal and paranasal sinus mass-like polyps from tumors. Methods: Dual-energy CT data of 80 patients with nasal sinus masses confirmed by surgical pathology were retrospectively analyzed. According to pathological results, the patients were divided into polyp group (n=26), benign tumor group (n=24) and malignant tumor group (n=30). Arterial phase iodine concentration (IC), normalized iodine concentration (NIC) and iodine map CT value (Overlay value) of lesions were measured, calculated and compared among 3 groups. Then patients in benign tumor group and malignant tumor group were combined into tumor group (n=54). ROC curves of each quantitative parameters of arterial phase iodine map for differentiating nasal and paranasal mass polyps and tumors were drawn, and the relative diagnostic efficacy were evaluated. Results: The arterial phase IC, NIC and Overlay value of benign tumor group (H=-4.13, -2.80, -4.00) and malignant tumor group (H=-7.02, -5.75, -6.12) were all higher than those of polyp group (all P<0.05). The arterial phase IC and NIC in malignant tumor group were higher than those in benign tumor group (H=-2.60, -2.73, both P<0.05), while Overlay value showed no statistical difference between benign and malignant tumor groups (H=-1.85, P=0.20). AUC of arterial phase IC (0.95) for differentiating nasal and paranasal mass polyps and tumors was larger than that of NIC (0.85) and Overlay value (0.91). Taken 1.15 mg/ml as the diagnostic threshold, the diagnostic sensitivity, specificity and Youden index was 81.50%, 96.20% and 78.00%, respectively. Conclusion: Arterial phase iodine-related quantitative parameters of dual-energy CT have certain application value in differential diagnosis of nasal and paranasal sinus mass-like polyps and tumors.