双能量CT成像标准化碘浓度评估食管癌T分期的可行性

发布时间：2018-03-15 02:38

本文选题：双能量　切入点：食管癌　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的利用DSCT双能量成像碘物质分离技术,探讨分析双能量CT成像标准化碘浓度(Normalized Iodine Concentration,NIC)评估食管癌T分期的可行性,为临床术前评估食管癌分期提供新的方法和参考指标。材料与方法选择广西医科大学第一附属医院2015年9月至2017年3月经病理证实的33例食管癌患者纳入研究。患者全部采用德国西门子公司第二代64排双源CT扫描仪(Siemens Somatom definition flash)进行双能量增强扫描。于病灶碘基物质图、融合图像上分别测量病灶主体标准化碘浓度、长度及厚度,并依据病理结果对食管癌T分期进行分组;采用拟合累积Logit回归模型对影响食管癌T分期的因素进行多因素回归分析,Spearman秩相关分析T分期与NIC及长度的相关性,采用单因素方差分析及多重比较对各组标准化碘浓度进行总体对比分析,并采用受试者工作特征曲线(ROC曲线)分析评估各期诊断效能。结果1、多因素回归分析:病变主体标准化碘浓度(NIC)及厚度是食管癌T分期的影响因素(P=0.004,0.038),病变长度不是食管癌T分期的影响因素(P=0.261)。2、Spearman秩相关分析:食管癌T分期与病变主体标准化碘浓度(NIC)、厚度及病灶长度呈正相关,分期越高,NIC越高、病灶厚度越大、长度越长(rs=0.661、0.685、0.459,P0.05)。3、方差分析:标准化碘浓度(NIC)在T2、T3与T4期差异均有统计学意义(P0.05),T2期:0.334±0.069、T3期:0.396±0.069,T4期:0.518±0.072。4、ROC曲线:以病灶主体NIC=0.346、0.489作为T2与T3、T3与T4的鉴别阈值,其灵敏度分别为77.8%、71.4%,特异性分别75%、92.9%,曲线下面积(AUC)分别为0.757、0.888。结论病变主体标准化碘浓度(NIC)及厚度是食管癌T分期的影响因素,NIC在T2、T3、T4期间分布具有差异性,可作为评估食管癌T分期的参考指标。
[Abstract]:Objective to investigate the feasibility of evaluating T stage of esophageal carcinoma by using DSCT dual energy imaging iodine separation technique, and to analyze the standardized iodine concentration in dual energy CT imaging and Normalized Iodine concentration ration (NICs). Materials and methods 33 patients with esophageal cancer confirmed pathologically from September 2015 to 2017 in the first affiliated Hospital of Guangxi Medical University were included in the study. All patients were scanned by Siemens Somatom definition flash, the second generation 64-row dual-source CT scanner of Siemens, Germany. The concentration, length and thickness of standardized iodine were measured on the fusion images, and the T stages of esophageal carcinoma were classified according to the pathological results. The regression analysis of the factors affecting T stage of esophageal cancer was carried out by fitting cumulative Logit regression model. The correlation between T staging and NIC and length was analyzed by multivariate regression analysis. Single factor analysis of variance (ANOVA) and multiple comparisons were used to compare and analyze the concentration of standardized iodine in each group. The diagnostic efficacy of each stage was evaluated by using the operating characteristic curve of subjects (ROC curve). Results 1. Multivariate regression analysis: the main body of the lesion was standardized iodine concentration (NICs) and thickness was the influencing factor of T stage of esophageal carcinoma. It is the influential factor of T stage of esophageal carcinoma. The correlation analysis of rank of P < 0. 261. 2 Spearman: the T stage of esophageal carcinoma is positively correlated with the standard iodine concentration and the thickness and the length of the lesion, and there is a positive correlation between the T stage of esophageal carcinoma and the main body of the lesion. The higher the stage was, the higher the Nic was, the greater the thickness of the lesion, the longer the length of the lesion, the longer the length of the lesion, the longer the lesion was, the longer the length was, the longer the lesion was, the longer the length was, the longer the length was, the greater the concentration of iodine was, the more significant the difference was between T _ 2T _ 3 and T _ 4. There was a significant difference between T _ 2T _ 3 and T _ 4, P 0.05 卤0.069 T _ 3 stage 0.396 卤0.069 T _ 4 phase w: 0.518 卤0.072.4 ROC curve: the main lesion was 0.3460.489 as the distinguishing threshold between T _ 2 and T _ 3T _ 3 and T _ 4, and the ROC curve was 0.396 卤0.069 T _ 4: 0. 3460.489 as the differential threshold between T _ 2 and T _ 3T _ 3. The sensitivity was 77.8% and 71.4%, the specificity was 75 ~ 92.9, and the area under the curve was 0.757 / 0.888.Conclusion the standard iodine concentration and thickness are the influencing factors of T staging of esophageal carcinoma, and the distribution of Nic in T _ 2 T _ 3 T _ 4 stage is different, and the distribution of Nic in T _ (2) T _ (3) T _ (4) stage of esophageal carcinoma is different. It can be used as a reference index for evaluating T stage of esophageal carcinoma.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.1;R730.44

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