双源CT鉴别诊断炎症性肠病反应性增生淋巴结与结直肠癌转移性淋巴结

发布时间：2018-01-05 21:32

本文关键词：双源CT鉴别诊断炎症性肠病反应性增生淋巴结与结直肠癌转移性淋巴结　出处：《中国医学影像学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨双源CT双能量扫描中碘含量及能谱曲线对炎症性肠病反应性增生淋巴结与结直肠癌转移性淋巴结诊断的临床价值。资料与方法收集有完整双能量扫描资料并经肠镜或手术病理证实的30例炎症性肠病(15例溃疡性结肠炎、15例克罗恩病)共51枚反应性增生淋巴结及20例结直肠癌共35枚转移淋巴结进行回顾性分析。测量反应性增生淋巴结及转移性淋巴结的碘含量;并比较2种不同病理性质淋巴结的能谱曲线斜率,采用受试者工作特性曲线,选取鉴别诊断2种不同病理性质淋巴结的最佳敏感度和特异度。结果动脉期炎症性肠病反应性增生淋巴结与结直肠癌转移性淋巴结碘含量分别为(2.66±0.70)mg/ml、(1.65±0.81)mg/ml,曲线斜率分别为2.81±0.56、0.14±0.09,反应性增生淋巴结与转移性淋巴结两者的动脉期碘含量及能谱曲线斜率差异均有统计学意义(P0.05)。且能谱曲线斜率对炎症性肠病反应性增生淋巴结与结直肠癌转移性淋巴结的诊断效能高于碘含量,其敏感度为96.7%,特异度为76.7%,曲线下面积为0.846。结论双源CT双能量动脉期测量碘含量及能谱曲线斜率对炎症性肠病反应性增生淋巴结与结直肠癌转移性淋巴结的鉴别诊断具有一定的意义,且能谱曲线斜率优于碘含量。
[Abstract]:Objective to investigate the clinical value of iodine content and energy spectrum curve in dual-source CT dual-energy scanning for the diagnosis of reactive hyperplasia lymph nodes and metastatic lymph nodes in inflammatory bowel disease. Data of 30 cases of inflammatory bowel disease confirmed by enteroscopy or pathology. 15 cases of ulcerative colitis. A retrospective analysis of 51 reactive proliferative lymph nodes and 35 metastatic lymph nodes was performed in 15 patients with Crohn's disease and 20 patients with colorectal cancer. The iodine content of reactive proliferative lymph nodes and metastatic lymph nodes were measured. The slope of two kinds of lymph nodes with different pathological properties were compared and the operating characteristic curves were used. The optimal sensitivity and specificity for differential diagnosis of two different pathological lymph nodes were selected. Results the iodine contents of reactive hyperplasia lymph nodes and metastatic lymph nodes in arterial phase inflammatory bowel disease were respectively (. 2.66 卤0.70 mg / ml. The slope of the curve was 2.81 卤0.56 卤0.14 卤0.09, respectively. There were significant differences in arterial iodine content and EDS slope between reactive and metastatic lymph nodes (P 0.05). The diagnostic efficacy of EDS curve slope on reactive hyperplasia lymph nodes and metastatic lymph nodes of colorectal cancer was higher than that of iodine content. The sensitivity was 96. 7 and the specificity was 76.7%. The area under the curve is 0.846.Conclusion the measurement of iodine content and the slope of energy spectrum curve of dual-source CT have certain value in the differential diagnosis of reactive hyperplasia lymph nodes and metastatic lymph nodes of colorectal cancer. The meaning of. The slope of the energy spectrum curve is better than the iodine content.
【作者单位】：昆明医科大学第一附属医院医学影像科;
【基金】：昆明医科大学研究生教育管理创新基金项目(2016S16)
【分类号】：R574;R730.44;R735.34
【正文快照】： 炎症性肠病(inflammatory bowel disease,IBD)为一类反复发作的消化系统慢性炎症肠道疾病,主要包括克隆恩病(Crohn's disease,CD)与溃疡性结肠炎(ulcerative colitis,UC)等。流行病学调查显示,在发展中国家近20年中本病发病率呈大幅上升趋势[1-2];国外文献报道,IBD已成为结直

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