CT能谱成像在胃腺癌分化程度评估中的应用价值

发布时间：2018-07-12 08:10

本文选题：体层摄影术 + X线计算机　；参考：《放射学实践》2017年04期

【摘要】：目的:探讨CT能谱成像(GSI)在评估胃腺癌分化程度中的应用价值。方法:87例经手术病理证实的胃腺癌患者,术前均行宝石CT能谱成像双期增强扫描,通过GSI Viewer分析软件获得病灶的能谱曲线,分别计算40~70、70~140及40~140keV各能量区间的能谱曲线斜率。同时测量病灶的碘浓度,并计算标准化碘浓度(病灶碘浓度与同层腹主动脉碘浓度的比值)。根据病理分化程度将患者分为中高分化组(36例)和低分化组(51例),采用t检验比较两组间能谱参数的差异。结果:动脉期:低分化腺癌和中高分化腺癌在40~70、70~140及40~140keV能量区间的斜率分别为2.89±0.74和2.04±0.41(P=0.001);0.41±0.12和0.28±0.08(P=0.004);1.15±0.30和0.81±0.17(P=0.001)。静脉期:2组病变在3个能量区间的斜率分别为5.28±1.23和3.73±0.65(P=0.000);0.79±0.20和0.53±0.12(P=0.001);2.13±0.51和1.49±0.28(P=0.000)。低分化腺癌的能谱曲线斜率均大于中高分化腺癌。以静脉期40~70keV能量区间的能谱曲线斜率的AUC(0.887)最大,以曲线斜率k=4.60作为阈值时,敏感度为70.6%,特异度为91.7%。动脉期和静脉期时低分化腺癌的碘浓度和标准化碘浓度比均高于中高分化腺癌,差异均有统计学意义(P0.01)。以静脉期标准化碘浓度比的AUC(0.889)最大,以0.458作为诊断阈值时,敏感度为94.1%,特异度为78.3%。结论:胃腺癌病灶的碘浓度、标准化碘浓度比以及能谱曲线与其组织学分化程度具有相关性,CT能谱成像能为术前评估胃腺癌的分化程度提供新的指标。
[Abstract]:Objective: to evaluate the value of CT energy dispersive imaging (GSI) in evaluating the differentiation of gastric adenocarcinoma. Methods 87 cases of gastric adenocarcinoma confirmed by operation and pathology were examined by double phase enhanced scanning with gemstone CT energy spectrum imaging before operation. The spectral curves of the lesions were obtained by GSI Viewer analysis software, and the slope of the energy spectrum curves of 40 ~ 7070 ~ 70 ~ 70 ~ 140 Kev and 40 ~ 140 Kev energy intervals were calculated respectively. At the same time, the iodine concentration of the lesion was measured, and the standardized iodine concentration (the ratio of the iodine concentration of the lesion to the iodine concentration of the same layer of abdominal aorta) was calculated. According to the degree of pathological differentiation, the patients were divided into middle and high differentiation group (36 cases) and low differentiation group (51 cases). T test was used to compare the difference of energy spectrum parameters between the two groups. Results: in arterial phase, the slope of low-differentiated adenocarcinoma and well-differentiated adenocarcinoma were 2.89 卤0.74 and 2.04 卤0.41 (P0. 001) 0.41 卤0. 12 and 0. 28 卤0. 08 (P0. 004), 1.15 卤0. 30 and 0. 81 卤0. 17 (P0. 001), respectively. The slope of the lesions in the venous phase: group 2 was 5.28 卤1.23 and 3.73 卤0.65 (P0. 000), 0.79 卤0. 20 and 0. 53 卤0. 12 (P0. 001), 2.13 卤0. 51 and 1. 49 卤0. 28 (P0. 000), respectively. The slope of energy spectrum curve of low differentiated adenocarcinoma was higher than that of middle and high differentiated adenocarcinoma. The maximum value of AUC _ (0.887) was obtained from the energy interval of 40 ~ 70keV in vein phase. The sensitivity and specificity were 70.6 and 91.7 when the curve slope was 4.60 and the sensitivity was 70.6 and the specificity was 91.7%. The iodine concentration and standardized iodine concentration ratio in poorly differentiated adenocarcinoma were significantly higher than those in well-differentiated adenocarcinoma at arterial and venous stages (P0.01). AUC _ (0.889) with standardized iodine concentration ratio in venous phase was the largest. When the diagnostic threshold was 0.458, the sensitivity was 94.1 and the specificity was 78.3. Conclusion: the iodine concentration, standardized iodine concentration ratio and energy spectrum curve of gastric adenocarcinoma lesions are correlated with the histological differentiation degree. EDS can provide a new index for preoperative evaluation of gastric adenocarcinoma differentiation.
【作者单位】：郑州大学第一附属医院放射科;
【基金】：国家自然科学基金面上项目(81271573)
【分类号】：R730.44;R735.2

【相似文献】