能谱CT分析进展期胃癌碘含量与脉管癌栓的相关性  

Correlation between iodine concentrations and lymphatic and/or vascular cancer emboli in advanced gastric cancer:Analysis with spectral CT

作　　者：刘玉良[1] 张晓鹏[1] 唐磊[1] 王之龙[1] 史燕杰[1] 李晓婷[1] 张晓燕[1] 孙佳[1] 孙应实[1] 

机构地区：[1]北京大学临床肿瘤学院,北京肿瘤医院,北京市肿瘤防治研究所医学影像科,恶性肿瘤发病机制及转化研究教育部重点实验室

出　　处：《中国介入影像与治疗学》2013年第7期413-417,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家重点基础研究发展计划(973计划)项目(2011CB707705);北京市卫生系统高层次卫生技术人才学科带头人培养计划(No.2011-2-21);首都特色临床应用研究(Z121107001012115)

摘　　要：目的应用能谱CT增强扫描分析进展期胃癌碘含量与脉管癌栓的关系。方法对40例经病理证实的进展期胃癌患者于术前2周内行能谱CT三期增强扫描,应用物质分离技术观察碘基图上增强扫描各期肿瘤黏膜侧高强化区及整体碘含量(ICs)、相同层面腹主动脉碘含量(ICao),计算标准化碘含量(NICs)、静脉期碘含量升高率(ICERvp),分析其与脉管癌栓的相关性。结果脉管癌栓阳性者胃癌动脉期黏膜侧高强化区、整体碘含量明显高于阴性者[(3.27±0.91)mg/ml vs(2.32±0.79)mg/ml,P=0.004;(1.98±0.65)mg/ml vs(1.41±0.75)mg/ml,P=0.023];标准化后脉管癌栓阳性者碘含量仍明显高于阴性者[(0.30±0.08)mg/ml vs(0.23±0.07)mg/ml,P=0.013;(0.18±0.06)mg/ml vs(0.14±0.07)mg/ml,P=0.037];阴性者黏膜侧高强化区及整体ICERvp明显高于脉管癌栓阳性者(0.39±0.26vs 0.12±0.26,P=0.005;0.55±0.46vs 0.22±0.28,P=0.047)。结论不同增强时相中胃癌碘含量与脉管癌栓存在一定相关性。Objective To analyze the correlation between iodine concentrations（ICs） and lymphatic and/or blood vessel tumor invasion（LBVI） in advanced gastric cancer with spectral CT enhanced scanning.Methods Multi-phase contrast-enhanced spectral CT was performed in 40 patients with advanced gastric cancer confirmed by surgical histopathology 2 weeks before operation.ICs in the highest enhancement area and whole tumor in different phases were derived from iodine-based material-decomposition CT images and normalized to the iodine concentration in the aorta,and the rate of enhancement in venous phase（ICERvp） was calculated.The differences in ICs,normalized iodine concentrations（NICs） and ICERvp between LBVI positive group and negative group were analyzed.Results ICs in the highest enhancement area and whole tumor of advanced gastric cancer of LBVI positive group in arterial phase（AP） were significantly higher than those of negative group（[3.27±0.91]mg/ml vs [2.32±0.79]mg/ml,P=0.004;[1.98±0.65]mg/ml vs [1.41±0.75]mg/ml,P=0.023）.NICs of LBVI positive group in AP were significantly higher than those of negative group（[0.30±0.08]mg/ml vs [0.23±0.07]mg/ml,P=0.013;[0.18±0.06]mg/ml vs [0.14±0.07]mg/ml,P=0.037）.ICERvp in the highest enhanced area and whole tumor of advanced gastric cancer of LBVI negative group were significantly higher than those of positive group（0.39±0.26 vs 0.12±0.26,P=0.005;0.55±0.46 vs 0.22±0.28,P=0.047）.Conclusion There is certain correlation between ICs of advanced gastric cancer in different phases and LBVI.

关 键 词：胃肿瘤 体层摄影术 X线计算机 能谱成像 碘含量 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]