单源双能CT碘基图对早期胃癌的诊断价值

发布时间：2018-03-10 03:20

本文选题：胃肿瘤　切入点：体层摄影术　出处：《中华临床医师杂志(电子版)》2016年23期 　论文类型：期刊论文

【摘要】：目的探讨单源双能CT碘基图对早期胃癌(EGC)的诊断价值。方法回顾性分析27例经手术病理证实为EGC的患者资料,所有患者均于术前行单源双能CT能谱成像(GSI)模式三期动态增强扫描,对三期增强图像进行碘-水配对基物质分离获得碘基图,并经后处理生成各期碘伪彩图(IPCM)。由两位观察者依据手术记录所示病灶位置对三期IPCM病灶检出情况进行评分,对评分结果的一致性进行Kappa检验,并计算各期病灶检出率,采用卡方检验比较。由两位观察者分别测量各期IPCM中病灶、正常胃壁以及同层主动脉的碘浓度,对两位观察者测量结果的一致性进行组内相关系数(ICC)检验,并计算病灶和正常胃壁的标准化碘浓度(NIC),采用配对样本t检验比较各期IPCM中病灶和正常胃壁NIC间的差异。结果两位观察者对各期IPCM病灶检出的评分结果一致性均很好(Kappa0.80),动脉期、静脉期及平衡期IPCM对病灶的检出率分别为81.48%、55.56%及14.81%,各期之间检出率比较均有统计学意义(P0.05)。两位观察者对各期IPCM中病灶、正常胃壁以及同层主动脉碘浓度测量结果的一致性均很好(ICC0.75),动脉期、静脉期及平衡期IPCM的病灶和正常胃壁的NIC分别为0.14±0.04和0.08±0.03,0.42±0.12和0.32±0.10,0.44±0.10和0.42±0.11,动脉期和静脉期病灶与正常胃壁NIC间差异均有统计学意义(t值分别为11.425和6.240,均P0.05),平衡期病灶与正常胃壁NIC间差异无统计学意义(t=2.007,P=0.055)。结论单源双能CT碘基图可以定量诊断EGC,动脉期IPCM对EGC的检出率高,具有较大临床价值。
[Abstract]:Objective to evaluate the diagnostic value of single source and dual energy CT iodide base imaging in early gastric carcinoma. Methods 27 cases of EGC proved by surgery and pathology were retrospectively analyzed. All patients underwent three phase dynamic enhanced scanning with single source and dual energy CT energy dispersive imaging (GSI) mode before operation. Iodine base images were obtained by separating iodine and water pairings from three phase enhanced images. After post-processing, the iodine pseudochromogram of each phase was generated. According to the location of the lesion recorded by the operation, the detection of the third stage of IPCM was evaluated by two observers, the consistency of the scoring results was tested by Kappa, and the detection rate of each stage of the lesion was calculated. The iodine concentrations of lesions, normal gastric wall and aorta in each stage of IPCM were measured by chi-square test. The consistency of the measured results of the two observers was tested by intragroup correlation coefficient (ICC). The standard iodine concentration of the lesion and normal gastric wall was calculated and the difference between the lesion and the normal gastric wall NIC in each stage of IPCM was compared by paired t-test. Results the results of the two observers' scores for each stage of IPCM were consistent very well, the arterial phase was 0.80%. The detectable rates of IPCM in venous phase and equilibrium phase were 55.56% and 14.81%, respectively. The consistency of measurement results of iodine concentration in normal gastric wall and aorta of the same layer was very good. The NIC of IPCM and normal gastric wall were 0.14 卤0.04 and 0.08 卤0.03 卤0.42 卤0.12 and 0.32 卤0.10 卤0.44 卤0.10 and 0.42 卤0.11, respectively. The difference of NIC in arterial phase and venous phase was 11.425 and 6.240, respectively (P < 0.05). There was no significant difference between NIC in normal gastric wall and there was no significant difference between them. Conclusion single source and dual energy CT iodide base imaging can be used to quantitatively diagnose EGC, and the detection rate of IPCM in arterial phase is high. It has great clinical value.
【作者单位】：大连医科大学附属第一医院放射科;
【分类号】：R735.2;R730.44

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