双能量CT对结直肠癌区域淋巴结性质判定的临床研究  

Clinical research of dual-energy CT diagnosis of the regional lymph nodes in colorectal cancer

作　　者：杨雪君[1] 赵卫[1] 郑凌琳 张帆[1] 杨亚英[1] 

机构地区：[1]昆明医科大学第一附属医院医学影像科,昆明650032

出　　处：《放射学实践》2016年第10期957-960,共4页Radiologic Practice

基　　金：云南省卫生科技计划资助项目(2014NS158)

摘　　要：目的:探讨双源双能量CT扫描后碘图中碘浓度及碘图CT值(Overlay值)在结直肠癌转移淋巴结与炎性淋巴结鉴别诊断中的价值。方法:30例结直肠癌患者进行双源双能量CT扫描,分别将双能量动、静脉期增强扫描图像调入双能后处理软件"Liver VNC",测量局域淋巴结实性部分的动、静脉两期的CT强化值、碘浓度及Overlay值。采用独立样本t检验进行比较,以P<0.05为差异具有统计学意义;并对其敏感性、特异性及受试者工作特性曲线(ROC)进行分析。结果:30例患者共检出105枚局域淋巴结,结直肠癌转移性淋巴结56枚,反应性增生49枚。结直肠癌转移淋巴结与反应性增生淋巴结动、静脉期强化CT值分别为(32.67±11.99)、(38.30±14.65)、(35.48±13.55)和(37.08±15.57)HU;碘浓度分别为(1.58±0.81)、(3.17±1.07)、(1.85±0.90)和(3.56±1.38)mg/mL;Overlay值分别为(35.41±14.66)、(59.58±21.20)、(41.19±14.74)和(65.52±21.46)HU。结直肠癌转移淋巴结与反应性增生淋巴结之间动静脉期碘含量及Overlay值及动脉期强化CT值差异均具有统计学意义(P<0.05),静脉期强化CT值差异不具有统计学意义(P>0.05);且动静脉碘浓度诊断转移淋巴结的诊断效能最高(敏感性为88.9%,特异性为73.2%,AUC为0.895)。结论:动脉期碘浓度结直肠癌转移淋巴及反应性增生淋巴结的影像鉴别诊断价值优于动、静脉期的于Overlay值及强化CT值。Objective：To explore the value of Iodine content and overlay value in dual-energy CT for differential diagnosis of the inflammatory and metastatic lymph nodes in colorectal cancer.Methods：30colorectal cancer patients recieved dual energy CT scan with pathologically confirmed 102 enlarged lymph nodes.The enhanced images of arterial and venous phases of dual energy CT were transferred to dual energy postprocessing software ＂ Liver VNC＂,the CT enhanced value,iodine concentration and overlay values of solid parts of the lymph nodes in arterial and venous phase were measured respectively.Results：30patients were detected with 105 pieces of local lymph nodes,metastatic colorectal cancer lymph node 56,reactive hyperplasia of 49.Colorectal cancer metastasis and lymph node hyperplasia of reactivity lymph node arterial and venous Ihase contrast enhanced CT value were（32.67±11.99）HU、（38.30±14.65）HU、（35.48±13.55）HU、（37.08±15.57）HU;Iodine concentration were（1.58±0.81）mg/mL、（3.17±1.07）mg/mL、（1.85±0.90）mg/mL、（3.56±1.38）mg/mL;Overlay values were（35.41±14.66）HU、（59.58±21.20）HU、（41.19±14.74）HU、（65.52±21.46）HU.Colorectal cancer metastasis and lymph node reactive hyperplasia of lymph nodes between arterial and arterial phase iodine content and overlay and venous phase of enhanced CT value differences were statistically significant（P〈0.05）,difference of enhanced CT value in venous phase is not statistically significant（P〉0.05）.Arterial iodine concentration was the most valuable in diagnosis of metastatic lymph nodes（the sensitivity,specificity and AUC was 88.9%,73.2%,0.895）.Conclusion：The imaging differential diagnosis of metastatic lymph nodes and reactive hyperplastic lymph nodes in the arterial phase is better than that of overlay and CT in the dynamic and venous phase.

关 键 词：结直肠肿瘤 淋巴结 假淋巴瘤 体层摄影术 X线计算机 

分 类 号：R735.34[医药卫生—肿瘤] R730.44[医药卫生—临床医学]