论著-头颈部
CT能谱成像在胃癌周围侵犯评价中的应用研究*
作者:欧阳华忠1 尹红军1 贾文霄2 杜江华3 王 皓3 王云玲3
所属单位:1.新疆生产建设兵团第七师医院 2.新疆医科大学 3.新疆医科大学第二附属医院 (新疆 830000)
PDF摘要
目的探讨双源CT双能量成像 在胃癌周围侵犯诊断中的应用价值。方 法 收集我院病理确诊为胃癌的64例患 者的临床资料,所有患者均行双源CT腹 部常规平扫和能谱增强扫描,根据病理 结果将淋巴结及脂肪组织分为转移组 与无转移组,并分别测量并比较其双 期标准化碘浓度(normalized iodine concentration,NIC)差异。结果 转移淋 巴结与非转移淋巴结动脉期的NIC值分别 是(0.545±0.087)、(0.143±0.078), 差异有统计学意义(P<0.05);静脉期的 转移性淋巴结与非转移淋巴结NIC值分别 是(0.478±0.014)、(0.306±0.083), 差异有统计学意义(P<0.05)。动脉期标 准化碘浓度>0.223时的诊断转移淋巴结 灵敏度为69.8%,特异度为91.2%;静脉期 标准化碘浓度>0.392的诊断灵敏度为 78.3%,特异度为85.6%。受侵脂肪组织与 未受侵脂肪组织动脉期的NIC值分别是 (0.651±0.351)、(0.001±0.180),差异 有统计学意义(P<0.05);静脉期NIC值分 别是(1.081±0.429)、(0.170±0.251), 差异有统计学意义(P<0.05)。动脉期标 准化碘浓度>0.150时,诊断受侵断脂肪 组织灵敏度为97.8%,特异度为86.7%;静 脉期标准化碘浓度>0.620的诊断灵敏度 为86.8%,特异度为98.8%。结论 能量成像 NIC值测定对胃癌周围侵犯的诊断有较大 的帮助,可作为胃癌预后评估的量化指 标。
Objective To investigate the value of dual-source CT energy imaging in the diagnosis of peripheral gastric cancer invasion. Methods We collected the complete data of 64 patients who has been diagnosed with gastric cancer in our hospital, all patients underwent dual-source CT abdominal routine scanning and energy spectrum enhancement scans. According to the pathologic results, the lymph nodes and adipose tissue were divided into metastatic and non metastatic groups, then measured and compared the difference of standardized iodine concentrations (Normalized Iodine Concentration, NIC) between the metastatic and the non metastatic of gastric cancer respectively. Results The NIC value of metastatic lymph node artery was (0.545±0.087), the non metastatic lymph node was (0.143±0.078), and the difference was statistically significant (P<0.05). The metastatic lymph node NIC in venous period was (0.478±0.014), and the non metastatic lymph nodes were (0.306±0.083), the difference was statistically significant (P<0.05). When the standardized iodine concentration in arterial phase was > 0.223, the sensitivity of the diagnostic lymph node was 69.8%, the specificity was 91.2%, and the diagnostic sensitivity was 78.3% and the specificity was 85.6% in the venous phase standardized iodine concentration > 0.392. The NIC values of the affected adipose tissue and the unexposed fat tissue were (0.651±0.351) and (0.001±0.180) respectively, and the differences were statistically significant (P<0.05). The NIC value of venous period was (1.081±0.429) and (0.170±0.251), and the difference was statistically significant (P<0.05). When the standardized iodine concentration in arterial phase was > 0.150, the sensitivity of invasive adipose tissue was 97.8%, the specificity was 86.7%, and the diagnostic sensitivity was 86.8% and the specificity was 98.8% in the venous phase standardized iodine concentration > 0.620. Conclusion The NIC value of energy imaging is helpful for the diagnosis of gastric cancer invasion, and can be used as a quantitative index for the prognosis evaluation of gastric cancer.
【关键词】胃癌;转移淋巴结;受侵脂肪;标准化碘浓度
【中图分类号】R735.2;R445.3
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2018.07.039
前言
胃癌主要转移途为经淋巴转移和直接蔓延,有研究表明早期、进 展期胃癌淋巴结转移率分别是10%、74.8%[1]。目前胃癌最主要的治疗 手段是手术,胃癌有无周围侵犯将直接影响胃癌分期、选择治疗方 案、术后复发及预后的评价,因此术前对胃癌周围侵犯的准确判断, 对胃癌治疗方案选择及淋巴结的清扫起到重要指导作用。能谱CT能够 提供更多的信息来协助图像分析,进行诊断。既往研究表明,多系 统病变利用能谱CT成像具有一定的价值,例如:肺癌和肺血流的灌 注[2]、胰腺和肝脏肿瘤的诊断与鉴别诊断[3-5]、胃癌的分期[6]等。本研 究的目的探讨胃癌周围侵犯组织标准化碘浓度差异的特征,评价能谱 成像NIC值对胃癌周围侵犯的诊断价值。
中国CT和MRI杂志
第16卷, 第 7 期
2018年07月
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